ACL Reconstruction Surgery: Diagnosis, Treatment, Precaution

1
ACL Reconstruction Surgery

• Diagnosis
• Treatment
• Precaution
• -Dr. A. M. Rajani (Consultant Knee and Shoulder
  Surgeon )

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Reconstruction of the Anterior Cruciate Ligament
(ACL)

• Reconstruction of the Anterior Cruciate
  Ligament (ACL) is a surgery designed to
  reestablish knee stability and strength after the
  ligament has been torn. The remnants of the torn
  ligament must be detached and replaced with a
  graft tissue harvested from the patients body.

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• The knee is a hinge joint where the femur, or
  thighbone, meets the tibia, or shinbone. This
  vital joint is held together by these four
  ligaments, which connect bones to one another
• Anterior cruciate ligament (ACL)
• Medial collateral ligament (MCL)
• Lateral collateral ligament (LCL)
• Posterior cruciate ligament (PCL)

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• The ACL runs crossways between the femur and
  the tibia and keeps the tibia from slipping in
  front of the femur. It also provides steadiness
  to the knee when it rotates from side to side. An
  ACL tear is one of the most common knee injuries,
  particularly among people who take part in
  high-impact sports like
• Basketball
• Football
• Skiing
• Hockey
• Soccer

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Diagnosis

• The diagnoses can habitually be made on the
  history and clinical exam alone. Analysis reveals
  shakiness of the knee, if sufficiently relaxed or
  not too painful. An MRI (Magnetic Resonance
  Imaging) can be supportive if there is qualm as
  well as to look for damage to other structures
  within the knee.

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Treatment

• Initial
• Rest
• Elevation
• Bandage
• Ice

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Long Term

• Not everybody needs operation. Some people can
  compensate for the injured ligament with
  strengthening exercises or a brace. It is
  strongly recommended to give up sports including
  twisting activities, if you have an ACL injury.
  Episodes of instability can cause further harm to
  important structures within the knee that may
  outcome to early arthritis.

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Surgery

• Surgical techniques have enhanced
  considerably over the last decade, difficulties
  are reduced and recovery much faster than in the
  past. The operation is performed arthroscopic
  ally. The ruptured ligament is detached and then
  tunnels (holes) in the bone are pierced to accept
  the New graft. This graft which substitutes your
  old ACL is taken either from the hamstring tendon
  or the patella tendon. There are benefits
  drawbacks of each with the final decision based
  on Mumbai knee surgeons preference.

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• The graft is equipped to take the form of a
  new tendon and passed from side to side the drill
  holes in the bone. The new tendon is then fixed
  into the bone with several devices to hold it
  into place while the ligament rebuilds into the
  bone (typically 7 months).The rest of the knee
  can be evidently pictured at the same time and
  any other injury is dealt with e.g., meniscal
  tears. The wounds are closed and a dry dressing
  applied.

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Post-Operation Precaution

• Surgery is performed as a day only process or an
  overnight stay.
• Any drains will be detached from the knee.
• A splint is sometimes used for ease.
• Leave any water-resistant dressings on your knee
  until your post-op evaluation.
• You can put your entire load on your leg.
• You have to put ice on the knee for 25 minutes
• at a time, as regularly as possible.

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• Post-op review will usually be at 5 to 10 days.
• Physiotherapy can initiate after a few days or
  can be prescribed at your first post-op visit.
• If you have any soreness around the wound or
  increasing aching in the knee or you have fever
  or feel unwell, you should contact your surgeon
  as soon as possible.
• You will have pain medication by tablet or in a
  drip.
• Avoid anti-inflammatories or aspirin for 10 to 15
  days.
• You will be seen by a physiotherapist who will
  show you to use crutches and show you some easy
  and simple exercises to do at home.