What is the procedure for ACL reconstruction?

ACL reconstruction or repair should be done in the patients with complete tears. Which is done with an arthroscopy procedure (keyhole surgery). In which the torn ligament will be replaced with new tissue graft taken from the patient’s own body. This tissue graft is commonly the tendon of thigh muscle attaching at the inner side of the knee.

How is the procedure done?

ACL reconstruction is usually performed by arthroscopic surgery with tendon graft taken from the patient’s own body which may be from hamstrings or quadriceps tendon, patellar tendon with bone at both ends or peroneus longus tendon. Graft is prepared to mimic ACL and then placed inside the joint at the place of ACL. Both the end remains within the bone tunnel of the femur and tibia bone. Fixation of the tendon graft is fixed within bone tunnel with a button or screw.

How does recovery happen?

ACL reconstruction recovery happens in a 6-8 months period post-surgery in which the rehabilitation or physiotherapy is staged. Initially the patient is on knee brace for 4-6 weeks and allowed to walk full weight bearing along with elbow crutches. Restricted range of motion of knee joint with ROM brace, exercises for knee muscle quadriceps strengthening, hamstring strengthening, hip strengthening, ankle pumps started at initial period. Gradually after 2-3 weeks more strenuous exercises are given like increasing knee ROM, body balancing and proprioception. Patients can walk without any aid after 4-6 weeks of surgery, followed by extensive strength exercises after 2-3 months and return to sport activities is expected after 8 months from surgery.

What should you expect from the procedure?

Success of the surgery depends on successful ligament conversion of the muscle tendon graft, which usually happens in 6-8 month time. During this time the graft remains most week at 2nd to 4th month of post-surgery. Strong well balanced knee muscle and gait can prevent the excessive stress and strain on the reconstructed ligament and help in better ligament conversion and strength gain. Post ACL reconstruction patients can expect good functional ability of the knee, recovery from instability, return to sports, ability to walk without any support. Swelling over knee and stiffness is expected for 2-3 months after surgery. More the rehabilitation one can do the more recovery and functional gain one can expect.

Why is this procedure done?

ACL reconstruction is advised to gain knee stability, regain functional capability, prevent further damage to knee; injury to other structures like meniscus and cartilage, development of arthritis.