Will my knee ever be the same after ACL surgery?
What is an ACL operation?
ACL surgery involves replacing a torn anterior cruciate ligament, which is the main ligament in the knee. Athletes most often need ACL surgery. The torn ligament is removed through small incisions around the knee joint and replaced with a piece of tendon from another part of the knee or a deceased donor.
When is it needed?
ACL reconstruction is usually needed in the following cases:
You are an athlete and want to continue playing sports, especially jumping, cutting or turning.
The ACL ligament is one of the main ligaments of the knee, which connects the femur to the lower leg, stabilizing the knee joint. The ligament is damaged whenever there is a direct blow to the knee, sudden stop, or change of direction.
A person may experience pain, swelling, or a feeling of instability in the knee in most cases. A few hours after the injury, there is usually a tendency to develop swelling, loss of motion in the joint, and tenderness or discomfort when walking.
How ACL tears happen
The ACL is one of the main knee ligaments, providing support for the knee while also preventing the knee from bending or flexing beyond its normal limits. Most injuries happen when the knee is forced to change direction quickly, like when pivoting while running. Injuries can also happen if you land hard after a jump.
ACL injuries typically involve knee pain, along with swelling, knee tenderness, and knee weakness or instability. You might also hear a pop or snapping noise when the tendon tears.
There are three levels of ACL injuries based on how the ligament is damaged:
- Grade 1 is mild stretching without a tear
- Grade 2 is stretching and a partial tear
- Grade 3 is a complete tear of the ligament
While we may treat mild injuries with bracing, activity modification, physical therapy, and other noninvasive treatments, complete tears almost always require surgery to repair — especially if you want to retain your active lifestyle.
How it’s done?
Before the procedure
Before the procedure, the patient is instructed when to stop eating, drinking, or taking medication, if necessary.
To reduce the risk of excessive bleeding, they may also be instructed to stop taking certain medications a week before surgery.
Depending on suitability, the graft is prepared by taking tissue from some other part of the body (autograft) or from another deceased donor (allograft).
During the operation
The patient is given general anaesthesia to ensure comfort and ease during the operation.
A small incision should then be made around the joint to use a thin tube camera and other instruments to operate.
The surgeon inserts arthroscopic instruments inside the joint and removes the damaged or torn ligament.
The incision is closed after graft replacement with sutures (either dissolvable or insoluble).
This operation is daycare. Most of the time, patients can go home the same day. Before being discharged from the hospital, patients are forced to practice walking with crutches.
Some of the most advanced Orthopedic Surgeons suggested by ACL reconstruction surgery provide detailed consultations related to post-op care at home for a pain-free recovery.
The recovery period after surgery
Pain management – the patient feels pain after surgery, which is part of the healing process. However, doctors prescribe pain medication for this short-term pain. These drugs include opioids, a local anaesthetic or ointment, and NSAIDs. Patients are advised to stop using these medications when the pain stops.
The first 10-15 days should be spent caring for the incision wound. Icing packs are used to reduce swelling and keep the legs elevated.
The patient should try to straighten the leg and gain control of the thigh muscles known as the quadriceps. Doctors sometimes recommend using knee braces and other machines to improve knee motion within its range.
The next stage of recovery includes a full set of knee movements and strengthening of the leg muscles, including the quadriceps and hamstrings.
The patient should continue approximately 4-6 months of physical therapy before returning to sports.
Cost of ACL reconstruction surgery
Some of the best orthopaedic hospitals in India perform the surgery at a very nominal cost. The hospitals are equipped with the latest devices and have experienced surgeons to perform the surgery with minimal access.