Anterior Cruciate Ligament Reconstruction
Anterior cruciate ligament injuries are common and the techniques available for treatment have evolved significantly in recent years. ACL reconstruction is now routinely performed arthroscopically, either as a day case procedure or, if performed very late in the day, with an overnight stay.
Usually, the anterior cruciate ligament is reconstructed using graft tendons harvested from the injured leg. These hamstring tendons are used to fashion a new cruciate ligament which is fixed securely into bone tunnels created during the surgery. Hamstring tendon harvested from the patients own body is called a hamstring tendon autograft, but occasionally other tendons or grafts are used, including hamstring harvested from the un-injured leg, patella tendon, and tendons transplanted from cadavers (known as allograft). Further information on the various types of graft available are available here. In younger patients who intend to return to competitive sporting activity an an additional reinforcing strap is often added on the outer side of the joint. This additional procedure reduces the risk of subsequent re-injury and is also offered to older patients whose knees are either very loose or very unstable.
Following ACL reconstruction, sterile adhesive dressings and a padded bandage are applied to the knee. Patients are mobilised weight bearing using 2 crutches, full weight bearing without aids as soon as they establish leg control. The padded bandage is removed 24 hours following surgery, leaving the original post-operative dressings undisturbed until the first post-operative follow-up appointment. At that appointment your wounds will be checked and your skin clips or sutures removed.
Physiotherapy will play an important role in your rehabilitation with early goals including the recovery of full straightening of the leg within a couple of weeks. Although you will be walking normally by this time, a return to competitive sport is usually delayed for between 6 and 9 months, with all patients following an accelerated rehabilitation program.
Further information regarding the procedure and the aftercare can be found here.