ACL Reconstruction

What is an Anterior Cruciate Ligament (ACL) procedure?

An ACL Reconstruction procedure replaces or repairs the major stabilising ligament of the knee after significant injury or damage.

Why is an ACL Reconstruction performed?

An ACL Reconstruction is usually performed on individuals who have experienced an injury from a high impact/sudden change in direction style injury.

The tell tale signs of a damaged or severed Anterior Cruciate Ligament are significant pain in the knee at the time of injury, combined with a feeling of a distinct 'pop' within the joint. Following on, weight bearing on the effected leg will be impossible without significant pain and buckling accompanied by rapid swelling.

How is an ACL Reconstruction carried out?

ACL can be carried out under a General Anaesthetic (you will be asleep) or Spinal/Epidural/Regional Anaesthetic (you will be awake). The procedure usually takes around one and a half hours to complete and is performed with a patient positioned on their back on the operating table throughout the procedure.
 
There are two methods of ACL Reconstruction available:

i) Using a portion of the Patellar Tendon to replace the damaged Cruciate Ligament
ii) Using the Hamstring Tendon.

Both methods have distinct advantages and disadvantages and your individual needs will need careful assessment to determine which is the best method for you. Both reconstruction methods are carried out arthroscopically (please refer to another fact sheet named Knee Arthroscopy for a detailed explanation) and involve:

i. Harvesting and preparation of new ligament material from either the Patella or Hamstring
ii. Arthroscopy Procedure to clean, trim or repair any torn cartilage within the damaged knee joint.
iii. Drilling of new insertion tunnels/fixing points in the thighbone and shinbone joint surfaces to secure the newly grafted ligament to.
iv. Fixation of the newly grafted ligament through the insertion tunnels with either screws or staples.    

Following on the surgical wounds are closed with absorbable stitches and dressed with a simple dressing. 

What is the recovery like?

Once a patient is fully recovered from the effects of anaesthetic they are quickly encouraged to be as active and mobile as possible to avoid joint stiffness or complications such as Deep Vein Thrombosis (DVT) from developing. It is therefore normal for patients to be connected to a special exercise machine known as a Continuous Passive Motion Devise immediately after surgery to get the newly operated joint on the move right from start.

Throughout recovery the emphasis will be on intense physiotherapy and rehabilitation, as the ultimate success of the reconstruction surgery depends on obtaining a full range of joint movement as early as possible after surgery. Following a progressive improvement of mobility and pain control patients are normally discharged home the day after surgery. By the time the required level of recovery is achieved for discharge, patients are normally wearing a simple wound dressing, eating and drinking normally, walking with the aid of crutches and taking only mild analgesia (pain killers).

Over the next 6 weeks patients will be expected to work on improving their own mobility and range of hip movement through dedicated and progressive physiotherapy and by increasing their daily activity and walking distances.

Your Consultant Surgeon will then assess your joints range of movement after 1 week, 6 weeks and then again after three months to evaluate how successful your surgery has been. Patients who are in employment should not resume work until after their first consultation and dependant on the physical nature of their job may be advised to take longer off work.

Patients should expect a continuous and full physical recovery to take up to nine months to achieve.

Are there any risks associated with ACL Reconstruction?

Although ACL Reconstruction is regularly performed without any complications, it is very important that all candidates are fully aware of both the benefits and risks of undertaking this type of specialist surgery.

All surgery, no mater how expertly or carefully it is performed, carries risks and the importance of a full evaluation and consultation with an expert in ACL surgery to discuss your condition in relation to these risks cannot be over emphasised.

How do I find out if I am a suitable candidate for ACL Reconstruction?

Surgical Advisor will be delighted to help you find a leading expert in knee surgery and ACL Reconstruction to consult with. Your surgeon will carry out a thorough evaluation of your condition and provide you with a comprehensive explanation of the most appropriate surgical solution.
 
Our Expert Consultant Orthopaedic Surgeons are most carefully selected and recommended because they understand the importance of the decision you are making when contemplating specialist knee surgery of this kind and because of their ACL reconstruction expertise. Throughout your consultation you will therefore be encouraged to ask as many questions as you wish and to take your time in making a decision to proceed with any recommended treatment.

To ensure that all patients are comfortable with any recommendations or advice given in their consultation, all patients are asked to go away after a consultation and think through all the information they have received. If for whatever reason you are still not sure about the best course of action and wish to have further dialogue with your surgeon, you will not be expected to pay for a second consultation appointment.

How do I make a consultation appointment?

For further advice on how to make an appointment to consult with an expert ACL Reconstruction surgeon: 

Please call Surgical Advisor on: 0870 41 41 41 2
Or email us by clicking on: advice@surgicaladvisor.com