Anterior Cruciate Ligament (ACL) Reconstruction
The information provided on this website is done so as a guideline to assist you in further understanding your surgical treatment and what to expect. Each patient’s treatment plan is tailored to their conditions so your rehabilitation may be quicker or slower than other peoples.
Please contact Dr Rodda for advice should you be concerned about any aspect of your health or recovery.
Anterior Cruciate Ligament (ACL) runs along the middle of the knee and controls the movement of the two main knee bones, the tibia and the femur. The ACL plays an important role in the knee for twisting, changing direction, turning and pivoting, so ALCL injuries commonly occur in sporting activities like netball and football. The ACL reconstructive surgery can sometimes be referred to as a ‘knee reconstruction’. ACL injuries are often traumatic, and commonly described as a ‘popping’ sound followed by excessive swelling and pain.
When you have injured your ACL there are two options presented to you. You can choose to try and rehabilitate with the aid of a knee brace and a tailored physiotherapy exercise plan. Occasionally an occupational therapist’s assistance will also be required. This, of course is dependent on whether your injury is stable and is suspected that it would respond well to rehabilitation. The second option is surgery, which is not without its own rehabilitation and healing time. As a knee reconstruction for ACL injury is normally considered an elective surgery, so it is important you consult with Dr Rodda and understand the facts and any risks associated with surgery.
Prior to surgery, your knee must be prepared appropriately, ensuring it is iced to reduce the swelling along with wearing your prescribed bandage or sleeve. This, as well as supporting the heel on a rolled towel and using the quadriceps at the front of the thigh to lock the knee straight out works toward restoring the full extension on the knee. Another exercise commonly used to help restore movement is cycling.
This procedure is performed arthroscopically, also referred to as keyhole surgery, under general anaesthetic. Using the tendon tissue of either the patient (an autograft, usually of the patella, quadriceps or hamstring tendon) or a donated tendon tissue (an allograft) a tunnel is created from inside the knee into the femur and tibia and in which the new tendon is passed through and fixed.
At the completion of the operation the surgical location is treated with a local anaesthetic. This will wear off slowly and following this you can use anti-inflammatory and pain medication. Your stitches do not require any dressing and you will not need to waterproof any wound as the stiches are dissolvable.
Most patients are discharged within one day, but it may vary depending on your level of injury. It is advised post-surgery that time is spent resting and with your knee elevated and continue to ice.
A few weeks after surgery, Dr Rodda will check your wounds and ensure your healing as planned. Exercises will then be recommended by a physiotherapist to encourage the extension of your knee, working to strengthen the muscles in the quadriceps and front of thigh.
- Pain and inflammation associated with injury to the knee should be alleviated
- Restored normality to your joint anatomy, static and dynamic stability, preventing further damage to other components of your knee
- Ability to regain a normal active lifestyle, including sporting activities and returning to work.
- Antibiotics are given at the time of surgery to reduce infection however infection of the wound can still occur and sometimes infect the joint. This is a serious complication and requires admission to hospital, additional surgery and intravenous antibiotics.
- Blood clots can form in the legs and can cause swelling below the knee. It is possible that the clot can dislodge and travel to the lungs causing pulmonary embolus, which can result in chest pain and breathing difficulties. Please advise Dr Rodda if you feel you are at high risk of blood clots.
- A small amount of numbness can be experienced on the outside of the knee. This generally disappears over time.
- In the case of needing a donor graft it is common to have a tearing sensation behind the knee for roughly 3-8 weeks after surgery. This is generally caused by the scar settling and stretching. This will settle with time.
- Pain following a patella graft can also be common. This usually settles within 9-10 months post-surgery.
Why should I consider ACL reconstruction surgery?
Surgery should be considered if you have suffered an injury to your ACL as a result of an accident or sporting incident and rehabilitation is not a suitable option to restore full mobility to the knee joint.
Who is suitable for surgery?
Most patients suffering from a torn ACL are suitable for surgery, however those at high risk of blood clots or patients with a history of medical conditions/complications should discuss this in detail with Dr Rodda before proceeding with surgical treatment.
How much pain is expected?
All surgical procedures involve a certain amount of pain and discomfort, however the use of ice packs and local anaesthetic after surgery, along with prescribed rehabilitation programs and exercises can reduce any pain and discomfort relatively quickly.
What happens after surgery?
Generally, patients can go home the same day or morning after their surgery. Prior to your discharge, you will be advised on how to perform post-operative exercises, along with how to use your crutches (you will need these for roughly 2-4 weeks). Bruising and swelling are also normal and will be ease by correctly following your instructions for recovery.
What happens once I’m home?
Following surgery, it is imperative that you rest during the first week you are home. You should spend majority of your time resting with your leg elevated and continue with regular icing of the knee. Your wounds will be checked a few weeks after the procedure to ensure that the wound is healing as expected. Dr Rodda will also perscribe exercises that encourage movement of the knee to extend out straight. You will also receive a physiotherapy program which is designed to restore function to the quadriceps.
When can I return to work?
This is heavily dependent on the type of work you do, so it is best to discuss this during your consultation with Dr Rodda. Returning to work can range from two weeks to three months post-surgery. Patients wanting to return to sporting activities can generally do so within 4-6 months of surgery, however it usually takes around 12 months to return to full functionality and mobility.