ACL Reconstruction Surgery: Diagnosis, Treatment, Precaution

1. ACL Reconstruction Surgery • Diagnosis • Treatment • Precaution • -Dr. A. M. Rajani (Consultant Knee and Shoulder Surgeon ) www.dramrajani.com

2. Reconstruction of the Anterior Cruciate Ligament (ACL) Reconstruction of the Anterior Cruciate Ligament (ACL) is a surgery designed to reestablish knee stability and strength after the ligament has been torn. The remnants of the torn ligament must be detached and replaced with a graft tissue harvested from the patient’s body. www.dramrajani.com

3. The knee is a hinge joint where the femur, or thighbone, meets the tibia, or shinbone. This vital joint is held together by these four ligaments, which connect bones to one another: • Anterior cruciate ligament (ACL) • Medial collateral ligament (MCL) • Lateral collateral ligament (LCL) • Posterior cruciate ligament (PCL) www.dramrajani.com

4. The ACL runs crossways between the femur and the tibia and keeps the tibia from slipping in front of the femur. It also provides steadiness to the knee when it rotates from side to side. An ACL tear is one of the most common knee injuries, particularly among people who take part in high-impact sports like: • Basketball • Football • Skiing • Hockey • Soccer www.dramrajani.com

5. Diagnosis The diagnoses can habitually be made on the history and clinical exam alone. Analysis reveals shakiness of the knee, if sufficiently relaxed or not too painful. An MRI (Magnetic Resonance Imaging) can be supportive if there is qualm as well as to look for damage to other structures within the knee. www.dramrajani.com

6. Treatment Initial: • Rest • Elevation • Bandage • Ice www.dramrajani.com

7. Long Term Not everybody needs operation. Some people can compensate for the injured ligament with strengthening exercises or a brace. It is strongly recommended to give up sports including twisting activities, if you have an ACL injury. Episodes of instability can cause further harm to important structures within the knee that may outcome to early arthritis. www.dramrajani.com

8. Surgery Surgical techniques have enhanced considerably over the last decade, difficulties are reduced and recovery much faster than in the past. The operation is performed arthroscopic ally. The ruptured ligament is detached and then tunnels (holes) in the bone are pierced to accept the New graft. This graft which substitutes your old ACL is taken either from the hamstring tendon or the patella tendon. There are benefits & drawbacks of each with the final decision based on Mumbai knee surgeon’s preference. www.dramrajani.com

9. The graft is equipped to take the form of a new tendon and passed from side to side the drill holes in the bone. The new tendon is then fixed into the bone with several devices to hold it into place while the ligament rebuilds into the bone (typically 7 months).The rest of the knee can be evidently pictured at the same time and any other injury is dealt with e.g., meniscal tears. The wounds are closed and a dry dressing applied. www.dramrajani.com

10. Post-Operation Precaution • Surgery is performed as a day only process or an overnight stay. • Any drains will be detached from the knee. • A splint is sometimes used for ease. • Leave any water-resistant dressings on your knee until your post-op evaluation. • You can put your entire load on your leg. • You have to put ice on the knee for 25 minutes at a time, as regularly as possible. www.dramrajani.com

11. Post-op review will usually be at 5 to 10 days. • Physiotherapy can initiate after a few days or can be prescribed at your first post-op visit. • If you have any soreness around the wound or increasing aching in the knee or you have fever or feel unwell, you should contact your surgeon as soon as possible. • You will have pain medication by tablet or in a drip. • Avoid anti-inflammatories or aspirin for 10 to 15 days. • You will be seen by a physiotherapist who will show you to use crutches and show you some easy and simple exercises to do at home. www.dramrajani.com