Anterior Cruciate Ligament Reconstruction

Anterior cruciate ligament (ACL) reconstruction is a surgical procedure used to repair a torn anterior cruciate ligament, which is one of the key ligaments that help stabilize the knee joint.

Indications for Surgery

• Patients with a complete tear of the ACL who are experiencing instability and difficulty with daily activities or sports.
• Patients with a partial tear of the ACL who have not responded to conservative treatment, such as physical therapy and bracing.
• Patients with associated injuries, such as meniscal tears or cartilage damage, that require surgical repair.

Surgical Techniques

There are several surgical techniques used for ACL reconstruction, including:

• Autograft technique: This involves using a piece of the patient's own tissue, such as the patellar tendon or hamstring tendons, to create a new ACL.
• Allograft technique: This involves using donor tissue to create a new ACL.
• Hybrid technique: This involves combining autograft and allograft techniques.

Surgical Procedure

The surgical procedure typically involves the following steps:

1. The patient is given general anesthesia or regional anesthesia to numb the area.
2. An arthroscope (a small camera) is inserted into the knee joint to visualize the damaged ACL and surrounding tissues.
3. The torn ACL is removed, and any associated injuries are repaired.
4. A graft is harvested from the patient's own tissue or obtained from a donor.
5. The graft is prepared and sized to fit the patient's knee joint.
6. Tunnels are drilled in the femur (thigh bone) and tibia (shin bone) to accommodate the graft.
7. The graft is inserted into the tunnels and secured with screws, staples, or other fixation devices.

Postoperative Care and Rehabilitation

After surgery, patients typically require several months of rehabilitation to regain strength, range of motion, and function in the knee joint.

• Immediate postoperative period: Patients are typically immobilized in a knee brace or splint for several weeks to protect the graft and allow it to heal.
• Early rehabilitation phase: Patients begin gentle exercises, such as straight leg raises and quadriceps sets, to maintain range of motion and strength.
• Advanced rehabilitation phase: Patients progress to more aggressive strengthening and agility drills to prepare for return to sports or daily activities.

Risks and Complications

As with any surgical procedure, there are risks and complications associated with ACL reconstruction, including:

• Infection
• Bleeding or hematoma
• Nerve damage
• Graft failure
• Knee stiffness or limited range of motion