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Rehabilitation After ACL Reconstruction

6th May 2021

ACL Reconstruction Treatment

ACL reconstruction is a common surgery to replace a torn anterior cruciate ligament (ACL), which is a major ligament in your knee. The ruptures occur during sports that involve sudden stops and changes in direction such as soccer, football, basketball and volleyball, making it a common injury among these athletes.

The ACL ligament comprises strong bands of tissue that attach one bone to another bone such as your shinbone (tibia) and thighbone (femur) and helps to stabilise your knee joint. However, any injury or damage to the ACL can cause your knee to give way during physical activity, most often during side-step or crossover movements.

For people who are relatively inactive, engage in moderate exercise and recreational activities, physical therapy can help treat their ACL injury. But for people who are highly active and want to continue in their sports, an ACL reconstruction rehabilitation  is generally recommended.

When combined with a focused rehabilitation programme, it can restore stability and function to the knee. And within the first few weeks after the surgery, you may regain a range of motion equal to that of your opposite knee. If you’re an athlete, it may take up to 3 months or more before you can return to your sports.

ACL Recovery | Spire Ortho

What is ACL surgery?

As with other surgical procedures, an ACL surgery is a procedure that replaces a torn ligament in a person’s knee. The torn ligament is generally replaced with a tendon, which connects the muscle to the bone.

  • When the tendon is put into the knee, it’s known as a graft. Surgeons typically use three types of grafts during an ACL surgery:

    ● Autograft involves the use of a tendon from other parts of your body like your other knee, hamstring, or thigh. This is the most common form of graft used

    ● Allograft uses tissue from someone else (a deceased donor).

    ● Synthetic graft involves the use of artificial materials such as silver fibres and silk. More advanced options include carbon fibres and Teflon.

If you have any queries, please discuss it with the surgeon as to the choice of graft used. This is because they are pros and cons with each particular option.

How is the surgery performed?

Before the surgery, you’ll likely undergo some physical therapy to reduce pain and swelling, restore your knee’s full range of motion, and strengthen your muscles. This is to increase your chances of regaining full range of motion after the surgery. Expect some changes to your diet and medicinal intake to reduce your risk of bleeding.

During an ACL reconstruction surgery, general anaesthesia is typically administered so that you’ll be unconscious during the surgery. With the help of knee arthroscopy, your surgeon will insert a tiny camera into your knee through a small incision and check the ligaments and other tissues of your knee using the monitor in the operating room.

Your surgeon will make other small incisions around your knee and insert other medical instruments to fix any other damage found and replace your ACL.

If you’re using your own tissue to replace your ACL, your surgeon will make a separate cut and remove your autograft. Your surgeon will then drill tunnels in your bone to bring the new tissue through and put them at the same place as your old ACL.

Your new ligament will then be secured to your bone with screws or other devices to hold it in place. As it heals, the bone tunnels fill in and hold the new ligament in place. At the end of the surgery, your surgeon will close the incisions with sutures (stitches) and cover the area with a dressing.

After the surgery

Once your anaesthesia wears off, you’ll be allowed to go home the same day. But before that, you’ll be asked to practice walking with crutches and your surgeon may ask you to wear a knee brace to help protect the graft.

You’ll also be given specific instructions to control the swelling and pain after surgery. Generally, it’s important to keep your leg elevated, apply a cold wrap or ice to your knee, and rest as much as possible. Your doctor may prescribe some medication to help with pain relief.

Once your ACL begins to heal, your doctor will recommend you to undergo progressive physical therapy to strengthen your muscles and ligaments, and ultimately to improve your knee’s flexibility. Depending on your physiotherapist, you’ll either be given a list of ACL rehabilitation exercises to perform at home or under their supervision.

For the best possible outcome, you should follow your rehabilitation plan to ensure proper healing. That way, you can return to playing the sports you like within a shorter recovery time.

Factors to consider before undergoing ACL surgery

  • Do you need this surgery?

If your knee is constantly buckling during any of your movement, you might need this surgery. This is because with every buckling episode, there is a risk that the meniscus may be torn and lock the knee in the process.

  • Are you willing to wait?

The choice on undergoing ACL surgery is largely dependent on the degree of swelling and the level of activity of the individual. During the normal process, the surgeon will normally wait for the swelling to subside before performing any operation. If a patient is an elderly and lives a latent lifestyle, conservative management with physiotherapy may be the option of choice.

  • Are you going to fully commit to your rehabilitation plan?

After the surgery, it’s all on you to get your knee moving again. You have to remain committed to your rehab to ensure a full recovery. The physiotherapist will guide you on when and what type of exercises on should undertake post operatively.

  • What’s your end game?

Do you want to stay active or lead a sedentary lifestyle? If it’s the former, you can choose to undergo this surgery. Unless it’s the latter, physiotherapy may suffice.

  • Can you afford the surgery ?

You may be able to claim your insurance for this operation. If your injury is from a sporting incident, do check with your insurance regarding claims under a personal accident insurance. Quite often, the public perceive accidents as merely involving road traffic incidents, however, this is not the case.

With these factors, you can either choose to push forward with your surgery or opt for physical therapy to strengthen your muscle and ligament.

In general, ACL reconstruction is highly recommended if you’re looking to repair a torn ligament and regain stability and movement in the knee. While not every case of torn ligament requires surgery, people who are active or experience persistent knee pain should opt for this surgery.

At Spire Orthopaedic Centre, everyone should be cared for and healed holistically in comfort without having to travel to different locations to seek medical and surgical help and rehabilitation support.

With a combined facility for collaboration between physicians, physiotherapists, and surgeons, you will experience a seamless service from diagnosis to treatment and rehabilitation, that’s tailored just for you at our clinic.