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ANTERIOR CRUCIATE LIGAMENT (ACL) RECONSTRUCTION

ACL (anterior cruciate ligament) reconstruction surgery is a procedure performed to repair or replace a torn ACL in the knee joint. The ACL is one of the major ligaments in the knee joint, and it provides stability to the knee by preventing excessive forward movement of the shin bone (tibia) relative to the thigh bone (femur).

The surgery is typically performed using a minimally invasive technique, called arthroscopy, where a small camera is inserted into the knee joint through small incisions. Dr Singh will use instruments to remove the torn ligament and replace it with a graft, which can be taken from the patient’s own body (autograft) or from a donor (allograft).

After the surgery, patients will typically undergo a rehabilitation program to regain strength, flexibility, and stability in the knee joint. The rehabilitation program may include physical therapy, exercises, and other treatments.

The success rate of ACL reconstruction surgery is generally high, with most patients being able to return to their normal activities and sports after several months of recovery. However, like any surgery, there are risks and potential complications associated with ACL reconstruction surgery, such as infection, bleeding, and blood clots so, it is important to discuss the risks and benefits of the surgery with Dr Singh to determine whether it is the right option for you.

Many people say that they hear a “pop” and experience immediate pain, swelling and knee instability and Dr Singh will usually recommend ACL reconstruction because the ligament cannot heal on its own to restore your knee function and mobility.

Surgical procedure

An ACL reconstruction is usually done arthroscopically using a small surgical camera and small, specialised instruments. During this procedure, Dr Singh will first obtain a tissue graft from you, or from a donor and the following steps are then taken:

  • The new tendon is prepared with anchor points called “bone plugs” which will graft the tendon into the knee.
  • A small incision is made in the front of the knee and the arthroscope is placed.
  • The inside of the knee is prepared with saline solution to allow Dr Singh to see your knee structures.
  • Small holes are drilled into the tibia and femur so the bone plugs can be attached.
  • The ligament is then attached at the drill sites.
  • Dr Singh then tests your knee’s range of motion and the tension of the graft to make sure it is secure.
  • The instruments are removed from your knee and the incision is stitched.
  • Your knee is dressed and wrapped, then immobilised with a brace.
  • Most patients can go home the same day as the surgery.

Immediately after surgery, you will be wheeled into a recovery room on your ward bed and given oxygen to help you breath. Leads will be on your chest to monitor your heart rate, and an intravenous line (drip) will be in your arm which dispenses fluid and paracetamol for the first 24-36 hours following your procedure. 

When you wake up in the recovery ward, you may feel a bit groggy. Dr Singh and the hospital team will monitor you, checking your blood pressure, temperature, and pulse and the nursing team at the hospital will help you perform your normal day to day activities as required. 

Recovery timelines

1.  Pre-Op

The ACL reconstruction surgery recovery process actually begins before you have your operation. Before surgery, Dr Singh recommends you see a physiotherapist who will go through rehab exercises for you to do in preparation. This is really important as increasing the strength and mobility of your knee before surgery can positively influence your surgical  recovery.

2. The day of surgery

ACL reconstruction surgery is usually done a few weeks after your initial injury. This is to allow for the swelling to go down, for you to regain movement and to build up the strength in your leg muscles.  

You may be allowed to go home on the day of your procedure or the following day, most likely with a pair of crutches.

3. Your first few days at home

For the first few days, the aim of ACL surgery recovery is to reduce swelling and minimise pain. This is done by using a combination of rest – ice – compression & elevation (R.I.C.E)

Remember, recovery after ACL surgery is a slow process, taking on average 9-12 months.

Discover more about knees

KNEE ANATOMY
KNEE CONDITIONS
KNEE SURGERY

Dr Aman Singh

M.B.ChB(NZ), FRACS (ortho)

Dr Singh works closely with local physiotherapists, radiologists, and other allied health members to ensure that your condition is treated without surgery where appropriate, or that post-operative recovery is as comprehensive as possible.

Dr Aman Singh

M.B.ChB(NZ), FRACS (ortho)

Dr Singh works closely with local physiotherapists, radiologists, and other allied health members to ensure that your condition is treated without surgery where appropriate, or that post-operative recovery is as comprehensive as possible.