An anterior cruciate ligament (ACL) tear or rupture can lead to symptoms of knee instability. If untreated, these episodes of instability can result in secondary damage to the meniscus and cartilage (gristle) in the knee and lead to arthritis. In the first instance, all patients with an ACL rupture should undergo a period of physiotherapy to strengthen their knee and improve their movement.
ACL Reconstruction Surgery
If you have symptomatic instability despite physiotherapy or if you are young and want to return to playing sport, an ACL reconstruction can be performed to restore the stability of the knee joint.
Dr Balendra is a specialist ACL surgeon. The ACL ligament reconstruction operation is performed by “borrowing” a tendon from your body to be used as a graft. Your hamstrings tendons are most commonly used, but the patella tendon or the quadriceps tendon can also be used. Dr Balendra will discuss the choice of graft with you in further detail. Once the tendon has been harvested, it is constructed into a suitable ACL ligament reconstruction and then passed into the knee through bone tunnels that have been drilled. The graft is secured with either metal or plastic screws.
Further information about ACL surgery can be found here.
ACL surgery will require you to spend a night in hospital. If there is no meniscus injuries that needs repair, Dr Balendra will allow you to start walking the day after surgery, though he would like you to use crutches to support yourself for the first two weeks.
Icing the knee to get the swelling down is critical to get a good outcome from surgery, and it is vital to try and get the knee straight (full extension) as soon as possible.
The physiotherapist will guide you through exercises to build up movement and strength within the knee. It takes most patient 3-4 months after surgery to regain full movement and strength within the knee. The physiotherapist will increase your activity levels over the next few months, but you cannot return to sport for at least 12 months after surgery.