Knee Ligament Surgery (ACL)
What is Anterior Cruciate Ligament Surgery?
Ligaments are tough tissues which connect bones that make up a joint, providing strong support and stability to the joint. The anterior cruciate ligament is one of the four major knee ligaments, the others being the posterior, medial, and lateral cruciate ligaments.
The anterior cruciate ligament is located in the centre of your knee joint, and serves to control the rotational and forward movement of the shin bone. The anterior cruciate ligament is the most commonly injured knee ligament.
Anterior cruciate ligament repair is done by replacing the torn ligament with a healthy tendon grafted from any part of your body such as your hamstring or kneecap. The tendon may also come from another donor.
Why is Anterior Cruciate Ligament Surgery Performed?
When you sustain a complete tear of your ACL, you would be needing surgery to repair it. Additionally, if you have an incomplete tear and your symptoms unresolved after using medications and conservative treatment options such as ice pack application, you would need surgery to repair the tear.
The ACL is commonly torn by a sudden twisting movement of the knee. Sports that predispose to an ACL injury include football, basketball, and skiing.
How is Anterior Cruciate Ligament Repair Performed?
Your doctor will discuss the procedure with you and answer your questions. You will also be given a consent form to sign, granting the surgical team the go-ahead to perform the surgery.
Your doctor will examine your knee and recommend certain blood tests to rule out any health condition that may complicate your surgery.
You will be asked to avoid intake of food and drinks 8 hours before the procedure, generally, avoid food after midnight before the day of the surgery.
ACL repair is usually performed as an outpatient procedure, unless you were on admission before it is done, in which case you would continue your stay in the hospital after the surgery.
Before the surgery, you will be asked to remove your clothes and wear a hospital gown. You may be administered a general anaesthesia which would keep you in a temporary deep sleep during the surgery, or a spinal anaesthesia in which case you will be awake, but unable to feel anything from your waist down.
The doctor will perform the surgery using tiny incisions in your knee through which a tiny camera and surgical instruments are passed. This approach is called arthroscopy.
Your doctor will re-attach or reconstruct the torn ACL with the tendon graft. If the doctor is reconstructing the ACL, holes will be drilled in the parts of your shin bone and thigh bone where the ligament was originally attached.
The tendon grafts are attached to these holes and held in place with surgical screws. The incisions are stitched back and dressed, then you are taken to the recovery room.
After satisfactory observation in the recovery room, you will be discharged or taken to your hospital room.
Your doctor will instruct you on how long to stay off work to allow proper healing of the ACL.
What risks are Associated with ACL Surgery?
As with any surgical procedure, an ACL repair may come with bleeding, clots in the knee, or persistence of your initial symptoms.