What is Anterior Cruciate Ligament (ACL) Surgery?

Anterior Cruciate Ligament (ACL) surgery is a procedure used to repair or reconstruct a torn ACL, one of the major ligaments in the knee that provides stability during movement. An ACL tear is a common injury, especially among athletes, and can significantly impact knee stability and function. ACL surgery involves replacing the damaged ligament with a graft, typically harvested from the patient’s own body (autograft) or from a donor (allograft).

How is ACL Surgery Done?

1. Preoperative Assessment: A thorough evaluation, including medical history, physical examination, and imaging studies like MRI, is conducted to assess the severity of the ACL tear and plan the surgery.
2. Anaesthesia: The surgery is performed under general anaesthesia or regional anaesthesia (spinal or epidural) to ensure the patient is pain-free during the procedure.
3. Incisions: Small incisions are made around the knee to insert an arthroscope and surgical instruments.
4. Removal of Torn ACL: The torn ACL is removed from the knee joint.
5. Graft Harvesting: The graft, either autograft (usually taken from the patellar tendon, hamstring tendon, or quadriceps tendon) or allograft, is prepared.
6. Graft Placement: The graft is threaded through tunnels drilled into the thigh bone (femur) and shin bone (tibia) and secured with screws or other fixation devices.
7. Closure: The incisions are closed with sutures or steri-strips, and a sterile dressing is applied to the knee.

Why is ACL Surgery Done?

ACL surgery is performed to restore knee stability and function, allowing patients to return to their normal activities, including sports and physical activities. It is typically recommended for individuals with a completely torn ACL, significant knee instability, or those who have not responded to conservative treatments like physical therapy and bracing.

Who Might Need ACL Surgery?

ACL surgery is recommended for individuals who experience:

• Significant knee instability that affects daily activities or sports.
• Recurrent episodes of the knee giving way during physical activities.
• A completely torn ACL, confirmed by imaging studies.
• Failure to improve with conservative treatments such as physical therapy and bracing.
• A desire to return to high-demand sports or activities requiring knee stability.

Conditions Treated with ACL Surgery

• ACL Tears: Complete or partial tears of the anterior cruciate ligament.
• Knee Instability: Chronic instability due to ACL injury.
• Combined Knee Injuries: ACL tears often occur with other knee injuries such as meniscus tears or cartilage damage.

Recovery Times

Recovery time after ACL surgery varies depending on the individual’s condition and adherence to rehabilitation. Generally:

• Initial Recovery: Patients usually go home the same day or the day after surgery.
• Physical Therapy: A structured rehabilitation programme begins shortly after surgery to restore range of motion, strength, and stability.
• Return to Light Activities: Light activities and desk work can often resume within a few weeks.
• Return to Sports: Most patients can return to sports and high-demand activities within 6 to 12 months, depending on their progress in rehabilitation.

Tips for a Good Recovery

1. Follow Postoperative Instructions: Adhere to your surgeon’s guidelines on wound care, activity restrictions, and medication.
2. Physical Therapy: Engage in a comprehensive physical therapy programme to regain strength, flexibility, and stability.
3. Rest and Elevation: Keep the knee elevated and avoid strenuous activities to reduce swelling.
4. Ice Therapy: Apply ice packs to the knee to reduce pain and inflammation.
5. Healthy Diet: Maintain a balanced diet to support healing and overall health.
6. Avoid High-Impact Activities: Gradually return to sports and high-impact activities as recommended by your surgeon and physical therapist.
7. Attend Follow-Up Appointments: Regular check-ups with your surgeon to monitor progress and address any concerns.

Conclusion

Anterior Cruciate Ligament (ACL) surgery is an effective solution for individuals suffering from ACL tears and knee instability. By reconstructing the damaged ligament, this procedure can significantly restore knee stability, improve function, and allow patients to return to their normal activities. If you are experiencing knee instability due to an ACL tear and conservative treatments have not provided relief, ACL surgery with Professor Ali Ghoz may be the right option for you. Consult with Professor Ghoz to discuss your condition and develop a personalised treatment plan tailored to your needs.