Anterior Cruciate Ligament Reconstruction

What is anterior cruciate ligament reconstruction?

Anterior cruciate ligament reconstruction is the surgical correction of the knee. The knee is usually held together by four different kinds of ligaments. They are the anterior cruciate ligament, the lateral collateral ligament, the medial collateral ligament, and the posterior cruciate ligament. A ligament connects one bone to another. The knee’s a type of joint where your thighbone connects with your shinbone. ACL reconstruction is thus targeted at correcting the anterior cruciate ligament. ACL runs in a diagonal manner from the thighbone to the shinbone. It prevents the bones from sliding over against each other. It also allows the knee to move by providing strength and stability to it. When this ligament gets damaged, it becomes hard for the knee to move normally. That is why it has to be reconstructed after it might have been damaged by whatever reasons.

In ACL reconstruction, the torn ligament is replaced with another one. The new ACL that will be replaced in the knee could be got from a dead body or another part of your body.

 

Anterior cruciate ligament injuries

People who partake in strenuous sporting events such as basketball, skiing, soccer, football, and hockey are the most susceptible to having an ACL tear. Most of these tears usually happen when a player pivots or twists while playing – based on research by the American Academy of Orthopaedic Surgeons – AAOS.

Not less than 200,000 ACL – related injuries cases are reported in the US every year. And not less than half of these people resort to an ACL reconstruction surgery according to a report from the AAOS.

 

Anterior cruciate ligament

Photo Credit: DocOPD

 

Why is anterior cruciate ligament reconstruction recommended and performed?

  1. To save a damaged ACL
  2. To restore strength and stability in knees
  3. To relief those who do not have a damaged ACL but are always in serious persistent pains
  4. To help athletes who care about remaining active
  5. To correct knees that buckle often while walking or during other routine activities

 

Getting ready for anterior cruciate ligament reconstruction

You can begin preparation for an ACL surgery if and only if you have first seen your doctor and you have agreed to undertake on. You will then be given a timeline for the surgery. But before this, he or she will examine your knees several times to be sure of what is about to be done on it. He will intimate you on the different treatment options, anesthesia choice, the source of the ligament implant, and any other thing he feels you should know ahead of time. Likely sources of the ligament implants are the patellar tendon, hamstring, quadriceps and a cadaver.

The patellar tendon attaches your kneecap’s bottom to your tibia (shinbone).

The hamstring is the tendon that joins the long muscles located at the back of your leg to the back of your knee

Quadriceps: it is the tendon located in front of your thigh. It is usually used for the implant for people who are taller, huge or have once had a failed knee reconstruction.

Cadaver: it is a dead body. Tissues can be extracted from cadavers. Tissues extracted from them are called allografts.

While all cadavers are carefully screened for disease prior to surgery, some people have concerns about using a dead tissue. Discuss any concerns you have with your doctor.

Your doctor will give you complete instructions for the day of your surgery. Instructions may include fasting for 12 hours prior to surgery and refraining from taking aspirin or blood-thinning medications.

Make sure to arrange to have someone come with you for surgery. It’s helpful to have another person listen to post-operative instructions and to drive you home.

 

How is anterior cruciate ligament reconstruction performed?

When it is time for you to be operated upon, you will be given a hospital gown to change into. Then you will be administered with an intravenous anesthesia, medication or sedatives through your arm.

Upon the collection and preparation of the tissue to be implanted, your tendon will be outfitted with anchor points or “bone plugs”. This anchor points will allow the tendon to be grafted into your knee.

During surgery, a small cut will be made right in front of the knee. This is where an arthroscope will be passed through. An arthroscope is a thin tube that has a fiber optic camera attached to it. It is outfitted to the knee alongside other surgical tools that can let your surgeon see the inside of your knee during surgery.

The next thing that will be done by the surgeon is to remove the torn ACL and then clean up the area.  Small holes will then be drilled in your tibia and femur. Bone plugs will together with posts, screws, staples, or washers, inserted into the holes.

Once the new ligament has been fixed, your knee’s range of motion will be tested by the surgeon. The knee’s tension will also be assessed to ensure that the graft is fine and secured. Then lastly, the wound dressed and the incision sewed. Your knee will then be stabilized with a strong brace.

The duration of the surgery depends on;

  1. The surgeon’s experience
  2. The use of additional procedures such as meniscal repair amongst other factors.

But you could actually return home that same day.

 

The Risks

  1. Loss of blood
  2. Blood clot formation
  3. Infection can enter the body through the opening in the knee.
  4. Continued pain in the knee operated upon.
  5. Transmission of diseases in cases where the graft is from a cadaver
  6. The stiffness of the knee operated upon.
  7. A weakness of the knee operated upon.
  8. Loss of range of motion
  9. Incomplete healing in when the immune system rejects the implant.

Kids with ACL tears have the risk of sustaining growth plate injuries. Growth plates are situated at the tip of bones. They are responsible for the growth and elongation of bones into adult size. When they are damaged, bones cannot grow longer. That is one risk kids have with an ACL reconstruction. Their growth will be hampered. To avoid this, they can be allowed to grow until their growth plates have been fully formed into strong bones.

You can be sure of a full recovery from an ACL reconstructive surgery. In fact, it has been reported that more than 80% of people that went for this surgery regained full knee stability.

 

After an anterior cruciate ligament reconstruction

After the surgical operation, you should expect to;

  1. Experience some pains in your knee where the operation had been undertaken
  2. Restrict your activities for a couple of months to avoid further damage and pains to the knee operated upon.
  3. Wear a knee brace for a minimum of a week.
  4. Wear crutches for about six weeks to avoid imposing stress on the knee
  5. Begin a physical therapy regimen

Rehabilitation is one thing that is pivotal to any ACL reconstruction success. You will be given some pain medications after the surgical procedures. The point where the cut is made into your knee will be cleaned and made dry. You will be advised to place ice on your knee that has just been operated upon. It is very good in preventing your knee from swelling as well as relieving you of any knee pains you might feel. You will be billed for a follow-up appointment a few weeks after the surgery. This is to check up on your current knee state.

But really, you should bounce back with the full use of your knees without any aid within a couple of weeks after surgery. If you are an athlete, you can get back to training in 6 -12 months’ time after the surgery.

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