ACL Reconstruction

ACL (Anterior Cruciate Ligament) Reconstruction is a surgical procedure performed to repair a torn or damaged ACL, a crucial ligament in the knee that provides stability during movements such as running, jumping, and pivoting. The procedure involves replacing the damaged ACL with a graft, usually taken from the patient's own tissue (autograft) or a donor (allograft). ACL reconstruction is commonly performed in athletes or active individuals who experience significant knee instability due to an ACL tear, as well as in patients whose injury significantly affects their daily activities and quality of life.

ACL tears typically occur during sports activities or physical activities that involve sudden stops, changes in direction, or jumping. Common causes include twisting motions, direct impacts to the knee, or hyperextension of the knee joint. When the ACL is torn, it can result in instability, pain, and difficulty performing certain movements, particularly those involving pivoting or bearing weight. In some cases, the injury may lead to other knee damage, such as meniscus tears or cartilage damage. When conservative treatments, like physical therapy or bracing, fail to restore knee stability, ACL reconstruction becomes necessary to prevent long-term knee damage and improve function.

The primary treatment for a torn ACL is reconstruction surgery, as the ACL does not heal well on its own due to limited blood supply. In ACL reconstruction, the surgeon removes the damaged ligament and replaces it with a graft, which serves as a replacement ACL. The graft is usually taken from the patient's own patellar tendon, hamstring tendon, or quadriceps tendon (autograft), although a donor graft (allograft) may also be used. The procedure restores knee stability, reduces the risk of further damage to other knee structures, and allows the patient to return to their pre-injury activities, including sports.

Before undergoing ACL reconstruction, patients undergo a thorough evaluation that includes imaging tests such as MRI or X-rays to assess the extent of the injury and any accompanying damage to the knee. The surgeon will discuss the surgical procedure, anesthesia options, and expected recovery timeline. Preoperative physical therapy is often recommended to reduce swelling, strengthen the surrounding muscles, and improve the knee's range of motion before surgery. Patients are also instructed to avoid certain medications, especially blood thinners, and to prepare for post-surgical care. Emotional preparation is also crucial, as ACL reconstruction requires a lengthy recovery period, including rehabilitation.

ACL Reconstruction is typically performed under general or regional anesthesia to ensure the patient is comfortable throughout the procedure. The surgeon makes small incisions (arthroscopic approach) to access the knee joint, removing the damaged ACL tissue. A graft, either from the patient's own body or a donor, is then inserted and attached to the tibia and femur using screws or other fixation devices. The graft serves as the new ligament, restoring stability and function to the knee. The procedure typically takes 1.5 to 2 hours, depending on the complexity of the injury. After surgery, the incisions are closed with sutures, and the knee is carefully bandaged.

After ACL reconstruction surgery, patients are closely monitored in the recovery room for complications, such as infection or blood clots. Pain management is provided through medications, and ice therapy is applied to reduce swelling. Most patients use crutches for the first few days to avoid putting weight on the knee. Physical therapy begins early, focusing on gentle range of motion exercises to prevent stiffness. Most patients can return to light activities within 4-6 weeks, but high-impact activities such as running or jumping are typically avoided until 6-9 months post-surgery. Recovery time varies depending on the individual and the extent of the injury, with full recovery typically taking 6-12 months.

Rehabilitation after ACL reconstruction is critical to restore full function, strength, and stability to the knee. Physical therapy starts immediately after surgery and focuses on regaining range of motion, reducing swelling, and gradually building strength in the quadriceps, hamstrings, and calf muscles. As the knee heals, patients progress to weight-bearing exercises, balance training, and sport-specific movements. Return to full activity and sports usually occurs between 6-9 months, although this can vary. Long-term recovery involves avoiding activities that place excessive stress on the knee and maintaining strength to prevent re-injury. Regular follow-ups with the surgeon ensure that the knee is healing correctly and that the graft is functioning well. With proper rehabilitation, most patients can return to their pre-injury activity level.