LIGAMENT TEAR - ACL RECONSTRUCTION
ACL reconstruction is surgical operation to substitute a torn anterior cruciate (KROO-she-ate) ligament (ACL) — a crucial ligament in your knee. ACL injuries most generally happen at the time of sports activities that has to do with abrupt stops and changes in direction — such as basketball, soccer, football, downhill snowboarding and gymnastics.
During ACL reconstruction, the ligament that has torn is eliminated and changed with a piece of tendon from a different part of your knee or from a deceased donor. This surgical procedure is an outpatient procedure that is carried out through small incisions around your knee joint.
ACL reconstruction is carried out by a doctor who has specialty in surgical procedure of the bones and joints (orthopedic surgeon).
Why it is done
Ligaments are strong bands of tissue that join one bone to the other. The ACL — one of two ligaments that crosses the center of the knee — joins your thighbone (femur) to your shinbone (tibia) and assists in stabilizing your knee joint.
Most ACL injuries occur at the time of sports activities that can put pressure on the knee:
· Suddenly slowing down and changing direction (cutting)
· Pivoting with your foot firmly planted
· Landing from a jump incorrectly
· Stopping suddenly
· Receiving a direct blow to the knee
Physical therapy may efficaciously treat an ACL injury for people who are not very active, engage in normal workout and leisure activities, or do sports activities that put less pressure on the knees.
ACL reconstruction is mostly suggested if:
You're an athlete and really wish to carry on in your sport, particularly if the sport includes jumping, cutting or pivoting
· The meniscus injured in your knee is more than one ligament
· The injury is causing your knee to buckle in everyday activities
ACL reconstruction is a surgical procedure. And, as with any surgery, bleeding and infection at the surgical area are can happen. Other dangers related with ACL reconstruction include:
· Knee pain or stiffness
· Poor recovery of the graft
· Graft failure after returning to sport
How you prepare
Prior to your surgery, you may undergo many weeks of physical therapy. The aim is to reduce pain and swelling before surgical treatment, mend your knee's full range of motion, and build up muscles. People who go into surgical treatment with a stiff, swollen knee may not regain full range of motion after surgery.
Food and medications
discuss with your doctor about any drugs or supplements you are taking. If you usually take aspirin or different blood-thinning medications, your doctor may ask you to stop taking these types of medication for at least a week prior to your surgical operation to minimize your risk of bleeding.
Follow your doctor's guidelines about when to stop eating, drinking and taking any other medication the night time before your surgery.
What you can expect
General anesthesia is normally used in the course of ACL reconstruction, so you may be comfortable all through the procedure. ACL reconstruction is normally carried out through small incisions — one to keep a thin, tube-like video camera (arthroscope) and others to enable surgical equipments get entry to the joint space.
During the procedure
Your doctor will do away with your damage ligament, and then substitute it with a part of tendon. This substitute tissue is known as a graft and it comes from different part of your knee or a tendon from a deceased donor.
Your doctor will drill sockets or tunnels into your thighbone and shinbone to precisely place the graft, which is then secured to your bones with screws or different fixation devices.
After the procedure
Once you get better from the anesthesia, you can go home later that same day. Before you go home, you will exercise taking walks with crutches, and your doctor may ask you to put on a knee brace or splint to assist guard the graft.
Your doctor will provide you precise instructions on how to manage swelling and pain after surgery. In general, it is necessary to maintain your leg elevated, use ice to your knee and rest as much as you can.
Medications to assist in reducing pain, over-the-counter medicine such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Your doctor may prescribe more medications, such as meloxicam (Mobic, Vivlodex, others) and gabapentin (Neurontin).
Follow your surgeon's recommendation on when to ice your knee, how long to use crutches and when it is safe to endure weight on your knee. You'll be advised when you can bathe, when you need to change dressings on the wound, and how to control post-surgery care.
Successful ACL reconstruction paired with forced rehabilitation can normally restore stability and function to your knee. Within the first few weeks after surgery, you have to try to regain a range of movement equal to that of your other knee. Recovery commonly takes about 9 months.
It can also take eight to 12 months or more sooner than athletes can return to their sports.