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ACL Reconstruction
WHAT IS AN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION (ACL) PROCEDURE?
An ACL Reconstruction procedure replaces or repairs the major stabilising ligament of the knee after significant injury and damage.
WHY IS AN ACL RECONSTRUCTION PERFORMED?
An ACL Reconstruction is usually performed on individuals who have experienced an injury from a high impact/sudden change in direction style injury. The tell tale signs of a damaged or severed Anterior Cruciate Ligament are significant pain in the knee at the time of injury, combined with a feeling of a distinct 'pop' within the joint. Following on, weight bearing on the effected leg will be impossible without significant pain and buckling accompanied by rapid swelling.
HOW IS AN ACL RECONSTRUCTION CARRIED OUT?
ACL Reconstruction can be carried out under a General Anaesthetic (you will be asleep) or Spinal/Epidural/Regional Anaesthetic (you will be awake). The procedure usually takes around one and a half hours to complete and is performed with a patient positioned on their back on the operating table throughout the procedure.
There are two methods of ACL Reconstruction available
a) using a portion of the Patella Tendon to replace the damaged Cruciate Ligament b) using the Hamstring Tendon. Both methods have distinct advantages and disadvantages and your individual needs will need careful assessment to determine which is the best method for you. Both reconstruction methods are carried out arthroscopically (please refer to fact sheet detailing Knee Arthroscopy) and involve:
1. Harvesting and preparation of new ligament material from either the Patella or Hamstring
2. Arthroscopy procedure to clean, trim or repair any torn cartilage within the damaged knee joint.
3. Drilling of new insertion tunnels/fixing points in the thighbone and shinbone joint surfaces to secure the newly grafted ligament to.
4. Fixation of the newly grafted ligament through the insertion tunnels with either screws or staples.
Following on the arthroscopy wounds are closed with absorbable stitches and a simple sticky dressing.
WHAT IS THE RECOVERY AFTER RECONSTRUCTION SURGERY LIKE?
Once a patient is fully recovered from the effects of anaesthetic they are quickly encouraged to be as active and mobile as possible to avoid joint stiffness or complications such as Deep Vein Thrombosis (DVT) from developing. It is therefore normal for patients to be connected to a special exercise machine known as a Continuous Passive Motion Devise immediately after surgery to get the newly operated joint on the move right from the start.
Throughout the recovery the emphasis will be on intense physiotherapy and rehabilitation, as the ultimate success of the reconstruction surgery depends on obtaining a full range of joint movement as early as possible after surgery. Following a progressive improvement of mobility and pain control patients are normally discharged home the day after surgery.
By the time the required level of recovery is achieved for discharge, patients are normally wearing a simple wound dressing, eating and drinking normally, walking with the aid of crutches and taking only mild analgesia (pain killers).
Over the next six weeks patients will be expected to work on improving their own mobility and range of hip movement through dedicated and progressive physiotherapy and by increasing their daily activity and walking distances.
Your Consultant Surgeon will then assess your joints range of movement after one week, six weeks and then again after three months to evaluate how successful your surgery has been.
Patients who are in employment should not resume work until after their first consultation and dependant on the physical nature of their job may be advised to take longer off work. Patients should expect a continuous and full physical recovery to take up to nine months to achieve.
ARE THERE ANY RISKS ASSOCIATED WITH ACL RECONSTRUCTION SURGERY?
Although ACL Reconstruction surgery is very commonly performed without any complications occurring, it is very important that all candidates are fully aware of both the benefits and risks of undertaking such surgery. All surgery, no matter how expertly or carefully it is performed carries risks and the importance of a full evaluation and consultation to discuss your condition in relation to these risks cannot be over emphasised.
HOW DO I FIND OUT IF I AM A SUITABLE CANDIDATE FOR ACL RECONSTRUCTION SURGERY?
At NW Specialist Clinic our Consultant Surgeons will carry out a full evaluation of your individual symptoms and circumstances and provide you with a comprehensive verbal and written explanation of your condition and recommend the most appropriate solution to improve your symptoms.
Our expert Consultant Surgeons understand the importance of the decision you are making when contemplating ACL Reconstruction Surgery. Throughout your consultation you will be encouraged to ask as many questions as you wish and to take your time in making a decision to proceed with any recommended treatment. If after your initial consultation you are still not sure about the best course of action and wish to have further dialogue with your surgeon, you will not be expected to pay for a subsequent consultation
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