ACL reconstruction and ACL repair both are same. The anterior cruciate ligament (ACL) is one of the 4 knee ligaments that connect the femur to the tibia and holds the bones of the knee together. It is the band of tissues in the knee that helps in keeping the knee stable. ACL is one of the commonly injured ligaments of the knee and most commonly occurs in players of high-risk sports, such as football, basketball, soccer, and skiing. Very rarely the only ACL is injured as any injury to the knee causes damage to other structures too.
An injury to ACL occurs when it stretches too much or tears apart due to overstretching. This can occur in the following conditions:
Many people hear a “pop” like voice when ACL gets injured. Also, in most of the cases, an injury to the ACL is often associated with injury to other knee structures and the symptoms revolve around knee including:
ACL injury requires thorough examination and diagnostics for its evaluation. The process of diagnosis involves the following:
In most of the cases of a minor ACL tear, non-surgical methods of treatment like RICE (rest, ice, gentle compression, and elevation), joint immobilization or physical therapy give relief to the patient. Recovery and rehabilitation of the ACL injury usually take at least 3 months.
In cases of complete ACL rupture or tear that is also associated with other joint injuries, surgery is indicated to repair or reconstruct ACL and treat the adjoining structures for complete joint relief. So, collaborated surgery is done to repair all the defects. Also, sewing of ACL doe does not allow proper healing of the ligament, so its repair is mostly done using a graft from some other part of the body like tendon of the kneecap (patellar tendon) or the hamstring tendons.
The surgery to repair or reconstruct torn ACL can be done as “open” surgery in which a large incision is given in the knee joint or as an “arthroscopic” surgery which is a less-invasive option and is done through various smaller incisions. Nowadays in most of the cases, the arthroscopic procedure opts for ACL repair.
The arthroscopic ACL repair can be done under general or local anesthesia, but general anesthesia is preferred to ensure the proper relaxing of the muscles surrounding the joint to conduct the procedure. It requires 4 small incisions in the knee joint to insert arthroscope and other small instruments in the knee joint for the surgery. In one of the ways, the surgeon uses hamstring tendon grafts to repair the torn ACL. But if the reconstruction of multiple ligaments is required then different graft materials may be used. Specially designed screws are used for immediate fixation of the graft into the knee.
Most of the patients can bear weight on the operated knee and walk comfortably soon after the surgery. Driving and other minor activities can be started the day after the surgery. Patients with a sitting job can resume work as early as 1-2 days, while heavy manual employment may require 6 weeks. It may take almost 6 weeks to start running in a straight line. Slowly other activities are introduced, and the patient can get back to a usual lifestyle within 6 months after the surgery.
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