ACL repair surgery is used for an injury to the anterior cruciate ligament (ACL) of the knee. Generally, this means you have torn the ligament, which connects tissue extending from the thighbone to the shinbone. Most likely, you’re now experiencing pain, swelling, less range of motion, and other symptoms from the tear and are looking for a solution to help with these symptoms and get back to your previous level of activity.
ACL repair surgery offers a solution to the tear to restore your tissue placement and function. While you may try nonsurgical treatment, there are times that ACL reconstruction is the recommended choice.
Let’s go over what you can expect from this type of surgery, so you can feel more confident about the next steps.
About ACL Knee Surgery
ACL surgery is an outpatient procedure. During this surgery, your surgeon will start by removing the current ligament that is torn. This is necessary because this ligament is damaged and no longer properly performing its function of stabilizing the knee joint.
Then, the surgeon will replace it with a new piece of healthy tendon, a graft, which is taken either from a different area of your own knee, hamstring or quadriceps and referred to as an autograft or obtained from deceased donor tissue and called an allograft. Adding the new ligament can help your knee function properly again, which is especially beneficial if you’re planning to maintain an athletic lifestyle or you injured more than one part of your knee. It may also be recommended for other reasons, so it’s best talk to an orthopedic surgeon about your particular situation if you haven’t already.
What Happens During the Procedure?
ACL reconstruction is usually done through a minimally invasive technique called knee arthroscopy, explains MedlinePlus. The surgeon makes small cuts around the knee and inserts a small camera and other instruments to perform the procedure. They use the camera to see what they are doing on a monitor, as they use other medical instruments to fix damage, remove the unhealthy tissue and add the replacement tissue.
The surgeon attaches the graft by drilling into the thigh and shin bones, positioning the replacement tendon, and using screws or other devices to hold it in place. Then, they use stitches to close the cuts made for the surgery and use a dressing to cover it. After the surgery, your body will take over to grow new tissue on the graft and to fill in the drill holes or tunnels. WebMD notes that arthoscopy surgery tends to create less scarring compared to open-knee surgery. Also, the procedure is over in about one hour.
Commonly, you would receive general anesthesia for this surgery. The general anesthesia allows you to sleep and not feel any pain during the procedure. Your surgeon may instead or also use regional anesthesia or other types.
How to Prepare for ACL Repair Surgery
Most likely, you wouldn’t have this surgery right away after your injury. While your course of action will depend on your individual case, it’s likely that you would participate in physical therapy of the knee area for a few weeks before your surgery. Mayoclinic.org explains that physical therapy helps reduce symptoms like pain and swelling and works to strengthen and improve muscles and range of motion. This progress can help the surgery be more effective, while surgery on a swollen knee that lacks range of motion may not have the range of motion restored.
You should plan to have someone drive you after the surgery, and you’ll be able to leave the same day as the procedure. Your doctor will have specific guidelines for you on eating and drinking the night before the procedure. Also, depending on medications or supplements you are on, your doctor may have you stop them for a period of time, at least the night before but possibly longer such as with a blood-thinner.
When the surgery is complete and you get over the effects of the anesthesia, your surgeon will go over anything you may need to wear, such as a splint or knee brace. Your medical team will have you walk with crutches to get used to them.
Then, your surgeon will give you recommendations on caring for your knee. This generally includes advice like keeping the leg elevated and using ice and rest to manage pain and swelling. These are probably things you were already doing after the injury and before the surgery. You’ll be told how to care for the dressing, how long to use crutches and similar information.
Your surgeon may also suggest over-the-counter pain drugs such as ibuprofen or acetaminophen, and/or may prescribe stronger pain medications. Most likely, you will have a rehabilitation plan with physical therapy to benefit flexibility and muscle strength.
It can take about nine months before your knee is fully restored, and up to one year to resume athletic activity.
Is ACL Reconstruction Effective?
It is possible for this surgery to come with complications. These may include infection, viral transmission, instability, stiffness or other complications. You can discuss these risks with your surgeon ahead of time. But overall, ACL reconstruction helps many people restore their knee stability so they can effectively engage in physical activity again.