ACL surgery is a repair or rebuilding of the anterior cruciate ligament (ACL). The ACL is a crucial soft-tissue component in the knee that joins the femur and tibia. ACL tears, whether partial or full, are a common injury among athletes.
How do you know if you need ACL surgery?
The need for surgery is determined by the degree of the ACL injury and the patient’s lifestyle. An ACL that has been fully torn cannot mend on its own. However, studies have shown that in some people with a partial tear of the ACL, the ligament may recover without the need for surgery.
People who have totally torn their ACL and lead an active lifestyle, particularly competitive sports, will require surgery to return to their previous level of activity and avoid further injury. Nonsurgical therapy may help certain senior individuals or those whose lifestyles do not include strenuous exercise to return to normal habits even if their ACL is not intact.
Partial and complete ACL tears
A doctor will perform two manual exams to identify whether a tear is partial or complete:
The Lachman test involves the physician attempting to move the shin bone away from the thigh bone. If the ACL is ruptured but still intact, the bones will either not move or move only minimally.
The pivot shift test involves the patient lying on their back as the doctor elevates their leg and applies rotating pressure on their knee. The test is negative if the bones do not shift.
In individuals with only a partial tear, it may be advisable to postpone surgery and check if the ligament recovery without it first.
ACL reconstruction surgery- Procedure
A new ACL is created during ACL reconstruction surgery from a graft of replacement tissue from one of two sources:
An allograft (tissue from a human organ donor) a part of the patient’s own hamstring, quadriceps, or patellar tendon. Each patient’s graft type is determined on an individual basis.
ACL repair surgery is carried out using minimally invasive arthroscopic techniques that make use of fiber optics, small incisions, and small devices. To obtain the tissue graft, larger incision is required. ACL reconstruction is an outpatient (ambulatory) operation that allows patients to go home the same day.
ACL repair surgery-An overview
The reconstruction of the ACL follows a series of basic procedures, which may differ significantly from case to case:
– The orthopaedic surgeon creates ports of entry for the arthroscope and surgical equipment by making small incisions around the knee joint.
– The arthroscope is introduced into the knee and a saline solution is delivered to increase the space around the joint. This frees up space for surgical equipment such as the arthroscopic camera, which sends footage to a monitor and allows the surgeon to look within the knee joint.
– The surgeon then examines the components that surround the torn ACL, such as the meniscus and articular cartilage. If either of these soft tissues has a lesion, the surgeon will fix it.
– Following that, the graft will be harvested (unless a donor allograft is employed). A graft is made by cutting a segment of tendon from another region of the patient’s body and attaching it at each end to bone plugs obtained from the patella and tibia. These plugs aid in the stabilization of the graft that will become the new ACL.
– Using a flexible guide wire, the surgeon inserts the new ACL into the femur and tibia.
Screws are used to secure bone plugs. These plugs will eventually fuse with the surrounding bone.
– To conclude the process, the surgical instruments are withdrawn.
Conclusion
In comparison to open surgery, which was formerly used for ACL restoration, arthroscopic surgical procedures have made recovery times shorter and easier. However, in order to have a satisfactory outcome, the patient must undergo rehabilitation under the supervision of a qualified physical therapist, as well as attend follow-up sessions with the surgeon. To know more regarding ACL injury and treatment plans, Schedule a consultation with Dr. Rishab Jaiswal, who is an expert in treating Sports injuries. If you have more questions about recovering after an ACL reconstruction, please give us a call or schedule to book an appointment.
