ACL Surgery

ARTHROSCOPY-KNEE-ACL SURGERY

ACL or Anterior Cruciate Ligament is a major ligament that connects two critical bones, the Femur (thigh bone) and Tibia (Shinbone). It helps in the rotational movement of the knee.

However, excess wear and tear of the joints and rigorous sporting activities can cause an injury to the ACL.

Causes

The injury of the ACL is a common occurrence during sports such as soccer, football, basketball, and skiing. The sudden jolt during jumping and landing leads to this injury. To correct this deformity, Orthopaedic Surgeons recommend a surgery known as ACL Reconstruction Surgery.

Signs and Symptoms of an ACL injury

If you have injured your ACL, you are likely to have pain and swelling in the knee. The swelling may increase over 6-8 hours, which could make the diagnosis difficult. An injured ACL makes a ‘pop’ sound during movement and you could have the strange feeling of the knees ‘giving way’. Straightening the knees could be extremely painful and walking, is a tedious task.

These symptoms should drive you to the nearest orthopaedic centre for confirmation of diagnosis.

Diagnosis

During the examination, the structures of the injured knee will be compared with that of the unhurt knee. Physical examination is enough to diagnose most of ligament injuries due to the evident symptoms. However, for a better understanding, a thorough examination is done using diagnostic tools such as magnetic resonance imaging (MRI) and X-rays. The images obtained present a clear outline of the type of injury in the bone. But these images tend to appear normal if the injury occurred over 3 months prior to diagnosis.

Managing an injured ACL

Treatment of ACL injury entirely depends upon the individual’s age, lifestyle, and level of activity. The ACL can be managed either non-surgically or through surgical interventions.

Non-surgical treatment or rehabilitation

The non-surgical treatment or rehabilitation involves strengthening of the joints and muscles around the knees to compensate for an unstable knee. Modification of activities and change of hobbies may be needed for best results.

Bracing may be needed to keep the knee stable. The individual can walk using crutches to prevent weight-bearing in the affected knee. With this method, the individual can resume his daily activities in a month but has to say goodbye to those activities, which could have deleterious effects on ACL.

Non-surgical methods are suitable for people with low activity levels and older adults.

Surgery

Arthroscopic ACL Reconstruction is done via key-hole surgery, wherein the torn ACL is reconstructed using a graft. This graft is extracted from your own body. Hamstring Tendon graft is the most common graft used. These tendons are dispensable and cause no long-term side effects.

Small tunnels are drilled in the bone to place the graft in the anatomical site of the ACL.

Types of ACL Surgeries

• Autograft: In this procedure, your doctor will use a tendon from a different part of your body in your knee as a replacement.
• Allograft: In this procedure, your doctor will replace the tendons on your knee after receiving it from someone else.
• Synthetic graft: In this procedure, your doctor will use synthetic material in place of your tendons like silver fibre, silk fibre, Teflon fibre, and carbon fibre.

How is post-op recovery after ACL surgery?

Some physical therapy under the guidance of physiotherapist guidance will help to regain the flexibility of the ligament, it will prevent the breaking of the tissue, and will help in strengthening the muscle tone.

Approximately 4-6 weeks are required for the bone to attach to the graft. However, the patient can start their normal activities like walking on their own and doing some exercises under proper observation and care.