In essence, an ACL injury occurs when the anterior cruciate ligament or the ACL (one of the major ligaments in the knee) is torn.
ACL injuries often result from sports that involve drastic directions and sudden stops like football, basketball, downhill skiing, volleyball, soccer, and gymnastics.
Treatment options can range from rehabilitation and rest to surgery, depending on the severity of the ACL injury.
The following are some of the primary goals of ACL surgery:
- Keep function loss to a minimum
- Restoring normal (or at the very least close to normal) knee stability
- Prevent injury and degeneration of other structures of the knee
Although surgery will not be necessary for all ACL tears, the patient and doctor will decide if rehabilitation and surgery will be best or rehabilitation alone would suffice.
Surgery is often the recommended option in the following scenarios:
- The ACL has been completely or partially torn, making the knee unstable.
- The patient wants to again participate in sports that will require knee strength and stability.
- The patient would be willing to commit to a long and rigorous rehab program.
- The patient has already gone through a rehabilitation program yet the knee is still unstable.
- The patient has a chronic ACL deficiency and the condition already affects the patient’s quality of life.
- Other knee parts (i.e. cartilage, tendons, meniscus) has also been injured.
Oftentimes, surgery is not required in the following cases:
- The tear is minor and responds well to rest and rehab.
- The patient is not involved in any job or sports that will require a knee that is stable.
- The patient can commit to a complete rehabilitation program that can help stabilize the knee and strengthen the leg muscles.
- The patient is suffering from other conditions that will make the ACL surgery risky.
While ACL surgeries are generally safe, there are still certain complications that can result from surgery and rehab such as:
- Damage to the nerves, structures, and blood vessels in and around the knee
- Blood clots in the legs
- Infection in the incisions
- Kneecap grating
- Stretching, loosening, and re-injury of the scar tissue
- Pain
ACL surgery can mean reconstructing or repairing the ACL.
- ACL reconstruction surgery involves replacing the ligament using a graft.
Autograft is the most common.
In essence, it means making use of the patient’s own body parts like the patellar tendon or the hamstring.
- Aliograft is another option, with the tissue taken from a deceased donor.
ACL repair surgery is performed when an avulsion fracture occurs.
This kind of fracture happens when a piece of the ligament and bone has been separated from the rest of the bone.
The procedure involves reattaching the bone fragment to the bone.
ACL injuries are performed by orthopedic surgeons.
In most cases, it is done by inserting surgical instruments through small incisions in the knee.
The method is called arthroscopic surgery.
In other instances, the procedure is carried out through large knee incisions.
The procedure is known as open surgery.
Many orthopedic surgeons prefer arthroscopic surgery over open surgery due to the following reasons:
- It has lesser risks
- Working and seeing the knee structures is a way easier
- The incisions are smaller
- It can be performed at the same time as a diagnostic arthroscopy
Arthroscopic surgery is performed under regional or general anesthesia.
It is also an outpatient procedure so patient will not be required to spend time in the hospital.
While swelling and numbness of the affected area will likely manifest after the surgery, it will eventually disappear after a few days.
If you are a candidate for ACL surgery, please visit www.bjios.sg for expert help.
