ACL reconstruction procedure uses a graft to replace the cruciate ligament. Autografts are the most common grafts which use part of your body, for example, hamstring tendons or patellar tendons or quadriceps muscles. Another form of the graft is allograft in which tissues from a deceased utilized. Arthroscopic surgery is used for an ACL reconstruction. In this surgery, small incisions are done on the knee through which surgical instruments are inserted. Sometimes it is also done by making a large incision which is called an open knee surgery. Anesthesia would be given at first to immune your knee from feeling anything. During the procedure, an arthroscope is inserted through one of the small incision. An arthroscope is a thin tube fitted with surgical instruments and a fiber optic camera. It helps the surgeon to get a view of the inside of the knee during the procedure. The torn ACL is first removed, and the area is cleaned. Small holes are drilled into the femur bone and the shin bone so that the bone plugs or anchor points to which the new tendons are outfitted, is attached with screws, posts or washers. After the new ligament is attached, the doctor would ensure that the graft is securely placed. Finally, the wound would be stitched; the knee would be dressed and stabilized with a brace. The duration of the whole surgery would depend on the severity of the problem as well as the experience of the surgeon. Usually, a patient is discharged one or two days after the surgery.
Usually, an ACL is done when the cruciate ligament that joins the shin and femur bone is injured. The treatment is done if one suffers from persistent knee pain or when the injury causes your knees to buckle while walking and other routine physical activities. Some jobs require one to do leg-work or athletes who want to continue to be in the profession actively can undergo the ACL reconstruction treatment.
ACL reconstruction is not meant for everyone with a ligament tear. Children can live without the treatment as their growth plates are still open, leaving a chance of a new ligament growing. There are instances where a ligament injury does not lead to instability symptoms.If the tear is partial and shows no trouble while engaging in low-demand sports, you can let go of the treatment and resort to nonsurgical treatments like therapy. People doing manual work or lives a sedentary life can also not undergo this treatment.
The patient might feel numbness in or around the surgery area. It is rare, but the treatment can damage the nerves or other tissues in or around the knee if the surgery was not done properly. The screws that are attached to the bone can cause problems like loosening and might require a removal. If tissues of a deceased patient are used in the surgery, there remains a high risk of getting infected. Surgery needs to be carried out in a strict non-germ condition in an operation theater. Despite these measures, there is a small percentage of chance of developing an infection in the joint.
It is oblivious that the area of surgery would be swollen and bruised. Applying ice packs would help in reducing the swelling and pain. There is a chance of the surgery area to get infected. It is advised to keep that area clean and dry and look for any sign of infection. It is safe to fully weight bear the knee right away, but usually, it is very comfortable to walk with some elbow crutches. Within two weeks the patient can walk normally. Physical rehabilitation after ACL reconstruction surgery is one thing that all doctors recommend. It is not advisable to return to competitive sport until at least ten months following the surgery.
The extent of time that it takes to recover after an ACL reconstruction surgery varies from one person to another. Physical rehab might take up quite a lot of time, from a few months to almost a year. Most people take near about six months after the surgery to return to the routine activities of life.
The cost of ACL treatment in India ranges from Rs.75000 to nearly 2 lakhs. It varies with the type of procedure, facility, surgeon and quality of implant. After the surgeries there are additional costs of Rs.15000 to Rs.20000 would be incurred in post-surgery physiotherapy or rehabilitation which is essential for a significant recovery.
The results of ACL treatment would be permanent most of the time if there were no mistakes in the surgery. It reduces stiffness and consistent pain in the knee. Especially for athletes, it is very much helpful and makes him/her return to the world of active sports.
Surgery is a common procedure to repair cruciate ligament tear. But surgeries have its issues, and thus many new and alternative treatments have been introduced. Stem Cell procedure is an alternative to the treatment of ACL reconstruction or repair. It extracts stem cells from an area where it is present in abundance and then concentrating and re-injecting them into the damaged area. The Platelet Rich Plasma (PRP) and also the Platelet LysateInjection Treatments are an alternative as well. The use of these treatments to repair tendons, ligaments and joints are becoming common nowadays.