ACL RECONSTRUCTION

ANTERIOR CRUCIATE LIGAMENT (ACL) SURGERY

The ACL is a major stabilising ligament of the knee particularly during movements such as running, twisting and sidestepping.

The function of the ACL is to prevent the femur moving forward and rotating excessively on the tibia. Reconstruction of the ACL will potentially reduce recurrent instability of the knee joint. Usually, patient who are more active and keener to return to sport involving twisting and pivoting will typically proceed to surgery. Repairing the ACL also protects the knee from further damage.

Reconstruction of the ACL is performed under a general anaesthetic. A tourniquet is inflated around your thigh to maintain a bloodless field during the surgery. Typically, two or three small incisions are made during a knee arthroscopy. One incision for the arthroscope and the others for the surgical instruments to treat the knee damage. A further 2-3cm incision will be made to harvest your hamstrings.

A piece of your hamstring will be used to reconstruct the anterior cruciate ligament. Fixation of the ligament will be achieved through a combination of a screw and endo-button. The key hole techniques usually allows for a more rapid recovery than open techniques as well as shorter recovery times following surgery. A check x-ray will be undertaken to endure satisfactory placement of the screw and endo-button prior to your discharge from hospital. An overnight stay is hospital would be typical for ACL reconstruction surgery, but some patients will go home on the same day if confident to do so.

Ice packs used regularly will help with reducing swelling following your surgery. Following your surgery, the physiotherapist will guide you through your rehabilitation. Following your surgery, your ACL graft should be strong enough to put all your weight on the operated leg. You will require crutches and pain killers initially for the first week or two. You may shower providing you have a waterproof dressing over your wounds.

Prof Reid will review your wound approximately 14 days after your surgery and our lovely nurse Sue will remove any stiches and redress your wound. Patients will need a minimum of 2 weeks off work. You can return to driving in the following circumstances:

Operated on left knee and you drive an automatic – You need to be off strong pain killers and able to carry out an emergency stop at speed.  You also need to be able to get out of the vehicle unassisted (in the event of an accident).  So you need to be confident about walking and manoeuvring unaided.  For some this will be at 2 weeks, for others it make be as much as 6 weeks.  Again, discuss this at your follow up appointment and wound check at 2 weeks.

Patients who are more active such as labourers may need 2 to 3 months off work. We recommend return to competitive sport only after 8-12 months following your surgery.  This is to reduce the risk of a recurrent injury and it is recommended an experienced physiotherapist helps guide you through your rehabilitation.