ACL Repair Surgery
An ACL, or anterior cruciate ligament, can be devastating, especially for an athlete, but it isn’t necessarily the career ending injury it once was. Luckily there are a variety of treatments that an orthopedic surgeon can do to repair an ACL injury. The road to recovery is often long and can be full of obstacle but thanks to new developments in arthroscopic procedures, the rate of successful ACL reconstruction is very high.
What is the ACL?
ACL stands for anterior cruciate ligament, which is one of the ligaments located in the knee that helps to regulate motion of the knee and leg. This ligament is critical for walking and a whole range of knee functions. When this ligament is damaged it can be incredibly painful as well as make mobility extremely difficult.
How is the Procedure done?
ACL repair surgery is typically done arthroscopically rather than through traditional methods of cutting the knee open. This greatly reduces the recovery time as well as scarring and risk of complications. When an ACL is damaged, the basic idea for repairing it is to graft some tissue onto the damaged section in order to strengthen it. There are two types of grafts that are used in ACL repair surgery, autografts and allografts. Autografts involve using tissues that are harvested from the patient’s own body while allografts use tissues that have been provided by a donor. Autografts are generally preferred, when possible because the rejection rate of one’s own tissues is much lower than that of tissue provided by someone else. There has also been some synthetic material developed for use in ACL repair surgeries. This material is relatively new and it isn’t yet clear how durable and effective this type of treatment is.
When tissue is taken from an autograft, it generally comes from an accessory hamstring or a patellar tendon. When it isn’t possible to take tendon from one of these locations, an allograft is generally used. This means that an Achilles, patellar, or anterior tibialis tendon will be taken from a cadaver and used for the procedure. Donor tissues must be sterilized and shaved to the correct size before they can be attached. There is some risk of rejection of donor tissues as well which would lead to another surgery to remove the tissues.
Once the graft or grafts have been selected, the surgeon will insert the arthroscope into the knee and begin to remove the damaged tissues. The new grafts will be attached on top of the weakened or damaged tissues and will function in place of them once healed. Once the tissues are attached, the surgeon will remove the tools and close the wounds. The knee is often placed in an immobilizing brace in order to keep the patient from moving it and potentially damaging the freshly finished work.
Recovery Period
Damaging an ACL is a major obstacle to mobility and recovery from an ACL repair operation can be extensive. Most patients will require therapy with a specialist that will initially focus on mobility and range of motion. It’s important to gain flexibility in the ligament after it has been damaged and then immobilized. These exercises are designed to do just that. For many, the rehab will begin immediately because the sooner a patient begins the rehabilitation process, the better the results will be with regards to reducing scar tissue. This is especially important for athletes. In some cases, a machine that continuously puts the joint in passive motion will be used as soon as the surgery is finished.
Generally speaking, it takes about six weeks for the graft to become fully attached. During this time, the patient may be able to walk with care but it is extremely important that they do not further injure the healing process. Following this period, more physical therapy is required to strengthen the joint as well as the muscles of the legs that have not been used during this resting period. Therapists will continue to focus on range of motion while adding strength training and mobility exercises such as jumping and zig zag patterns. The overall length of time required to heal this type of injury varies greatly but the rate of successful ACL reconstruction is high.
What is the ACL?
ACL stands for anterior cruciate ligament, which is one of the ligaments located in the knee that helps to regulate motion of the knee and leg. This ligament is critical for walking and a whole range of knee functions. When this ligament is damaged it can be incredibly painful as well as make mobility extremely difficult.
How is the Procedure done?
ACL repair surgery is typically done arthroscopically rather than through traditional methods of cutting the knee open. This greatly reduces the recovery time as well as scarring and risk of complications. When an ACL is damaged, the basic idea for repairing it is to graft some tissue onto the damaged section in order to strengthen it. There are two types of grafts that are used in ACL repair surgery, autografts and allografts. Autografts involve using tissues that are harvested from the patient’s own body while allografts use tissues that have been provided by a donor. Autografts are generally preferred, when possible because the rejection rate of one’s own tissues is much lower than that of tissue provided by someone else. There has also been some synthetic material developed for use in ACL repair surgeries. This material is relatively new and it isn’t yet clear how durable and effective this type of treatment is.
When tissue is taken from an autograft, it generally comes from an accessory hamstring or a patellar tendon. When it isn’t possible to take tendon from one of these locations, an allograft is generally used. This means that an Achilles, patellar, or anterior tibialis tendon will be taken from a cadaver and used for the procedure. Donor tissues must be sterilized and shaved to the correct size before they can be attached. There is some risk of rejection of donor tissues as well which would lead to another surgery to remove the tissues.
Once the graft or grafts have been selected, the surgeon will insert the arthroscope into the knee and begin to remove the damaged tissues. The new grafts will be attached on top of the weakened or damaged tissues and will function in place of them once healed. Once the tissues are attached, the surgeon will remove the tools and close the wounds. The knee is often placed in an immobilizing brace in order to keep the patient from moving it and potentially damaging the freshly finished work.
Recovery Period
Damaging an ACL is a major obstacle to mobility and recovery from an ACL repair operation can be extensive. Most patients will require therapy with a specialist that will initially focus on mobility and range of motion. It’s important to gain flexibility in the ligament after it has been damaged and then immobilized. These exercises are designed to do just that. For many, the rehab will begin immediately because the sooner a patient begins the rehabilitation process, the better the results will be with regards to reducing scar tissue. This is especially important for athletes. In some cases, a machine that continuously puts the joint in passive motion will be used as soon as the surgery is finished.
Generally speaking, it takes about six weeks for the graft to become fully attached. During this time, the patient may be able to walk with care but it is extremely important that they do not further injure the healing process. Following this period, more physical therapy is required to strengthen the joint as well as the muscles of the legs that have not been used during this resting period. Therapists will continue to focus on range of motion while adding strength training and mobility exercises such as jumping and zig zag patterns. The overall length of time required to heal this type of injury varies greatly but the rate of successful ACL reconstruction is high.