Introduction to Anterior Cruciate Ligament (ACL) Reconstruction

Anterior Cruciate Ligament (ACL) reconstruction is surgery to rebuild the ligament in the center of your knee with a new ligament. The anterior cruciate ligament (ACL) keeps your shin bone (tibia) in place. A tear of this ligament can cause your knee to give way during physical activity.

ACL damaged when twisted too far, such as in a skiing injury.

ACL Reconstruction is performed using a combination of open surgery and arthroscopy

  

What are risks of ACL Reconstruction?

ACL reconstruction is a surgical procedure. And, as with any surgery, bleeding and infection at the surgical site are potential risks. Side-effects are the unwanted but mostly temporary effects you may get after having the procedure, including

  • pain
  • swelling and bruising
  • stiffness

How is ACL Reconstruction performed?

ACL reconstruction can be done using either local or general anesthesia. 90% of patients will do the ACL reconstruction under general anesthesia. This means you will be asleep and pain-free and not eating or drinking, typically for about six hours beforehand.
  • Before the ACL reconstruction process begins, Dr Kevin Yip will examine your knee arthroscopically, and repair any additional damage to the knee, such as a torn meniscus, or worn articular cartilage.
  • Dr Kevin Yip will examine your knee to check how badly your ligament is torn and whether any other tendons or ligaments have been damaged.
  • Dr Kevin Yip will make a number of small cuts in the skin over your knee that is being treated. He will insert an arthroscope and other surgical instruments into your knee through these cuts. An arthroscope has a thin, flexible tube with a light and camera on the end of it. It allows Dr Kevin Yip to see inside your knee.
  • Dr Kevin Yip will remove the piece of tendon that will be used as the graft. He will usually take the graft from your patella tendon, which connects your kneecap and shin bone, or from one of your hamstring tendons at the back of your knee.
  • Dr Kevin Yip will drill a tunnel through your upper shin bone and lower thigh bone. He or she will put the graft into the tunnel, attach it to the bones and fix it in place, usually with screws. These are normally left inside your knee permanently. Dr Kevin Yip will then close the cuts with stitches or adhesive strips.

The operation usually lasts between one and a half and two hours.

Why is ACL Reconstruction performed?

NOT treating a torn ACL can lead to tissue damage and early arthritis. ACL reconstruction may be recommended for these knee problems:

  • Knee that gives way or feels unstable during daily activities
  • Knee pain
  • Inability to continue playing sports or other activities
  • When other ligaments are also injured

What to expect after surgery

  • May go home the day of your surgery or the very next day with bulky dressing over your knee. The bulky dressing will normally be removed 3 days after the surgery in clinic.
  • May need crutches for 1 to 4 weeks. Most people are allowed to move their knee right after surgery to help prevent stiffness.
  • May need medicine to manage your pain. E.g. antibiotic, anti-inflammatory and pain relief medication.
  • Physical therapy can help many people regain motion and strength in their knee. Therapy can last 2 to 6 months.
  • Return to work can be few days or few weeks depending on what kind of work
  • A full return to activities and sports usually takes 4 to 6 months

Prognosis

ACL reconstruction is usually very successful. A torn ACL used to end the careers of many athletes. Now, improvements in the surgery and in rehabilitation provide much better results. These improvements include less pain and stiffness, fewer complications with the surgery itself, and faster recovery time. Most people will have a stable knee that does not give way after ACL reconstruction.

For more information, please call (65) 6476 2106

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