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ACL Reconstruction - Treatment, Procedure And Side Effects

What is the treatment?

ACL refers to the Anterior Cruciate Ligament. Anterior Cruciate Ligament with other four main ligaments located in the knee.The knee joint is held together by Medical Collateral Ligament (MCL), Lateral Collateral Ligament (LCL), Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament. Being located in the center of the knee, it helps to keep the shin bone or tibia in place. ACL reconstruction is a tissue graft surgery to reconstruct or repair the ligament of the knee. A tear of this ligament can become a hazard in your physical activities. The particular cruciate ligament is usually not required for day-to-day operations, but it is used to control the rotation forces developed during pivoting, landing from a jump or side-stepping. ACL injury is common while skiing or playing running ball sports. A person may feel hear a snap or a crack. Swelling and knee pain shortly follows. The ACL is surrounded by joint fluid, utilized unlike other ligaments about the joint. Other ligaments heal by scar formation, however, due to the unique location of the ACL, the bleeding is uncontained, filling the joint, causing pain and swelling.It can be a small tear for which rest or physical rehab would work well, but if the injury is severe, then ACL reconstruction is to be done.

How is the treatment done?

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.

Who is eligible for the treatment? (When is the treatment done?)

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.

Who is not eligible for the 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.

Are there any side effects?

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.

What are the post-treatment guidelines?

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.

How long does it take to recover?

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.

What is the price of the treatment in India?

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.

Are the results of the treatment permanent?

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.

What are the alternatives to the treatment?

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.

Safety: Medium Effectiveness: Medium Timeliness: Medium Relative Risk: High Side Effects: High Recovery Time: High Price Range: RS. 75,000 - Rs. 2,00,000 and above

Popular Health Tips

Why Are Doctors Opting For ACL Reconstruction?

M S Ortho, D - Ortho, MBBS Bachelor of Medicine and Bachelor of Surgery
Orthopedist, Mumbai
Why Are Doctors Opting For ACL Reconstruction?
The anterior cruciate ligament (acl) is a rope like connective tissue that gives support and stability to the knee, along with other related tissues. If you do not repair it, you can still perform many functions, and carry on with your life with l...
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Frequently Asked Questions About ACL Reconstruction Surgery!

MS - Orthopaedics, MBBS Bachelor of Medicine and Bachelor of Surgery, DNB - Orthopedics & Orthopedic Surgery
Orthopedist, Hyderabad
Frequently Asked Questions About ACL Reconstruction Surgery!
ACL which stands for Anterior Cruciate Ligament is a common form of injury for people involved in sports. Tear of ACL can be an extremely painful and debilitating injury. The prospect of having to undergo a surgery for reconstruction will definite...
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What to Expect During ACL Surgery Recovery?

MS - Orthopaedics, MBBS
Orthopedist, Delhi
What to Expect During ACL Surgery Recovery?
ACL Surgery is basically Anterior Cruciate Ligament reconstruction, which is carried out for patients suffering from damaged ligaments which can lead to stiffness, pain and decreased mobility among a host of other symptoms and ailments. This kind ...
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Anterior Cruciate Ligament Tear - How To Recover?

MBBS, MS - Orthopaedics, Fellowship in Arthroscopy & Arthroplasty Shoulder & Knee
Orthopedist, Gurgaon
Anterior Cruciate Ligament Tear - How To Recover?
The Anterior Cruciate Ligament or ACL tear is a very common problem with athletes and with people who have an active lifestyle. In fact, this can also be caused by any accident due to sudden movement. Importance of ACL- The ACL is the supporting l...
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ACL Reconstruction Surgery - What To Know?

MBBS Bachelor of Medicine and Bachelor of Surgery, MS - Orthopaedics, DNB - Ortho, Fellowship In Knee Replacement & Arthroscopic Surgery ( Knee & Shoulder )
Orthopedist, Mumbai
ACL Reconstruction Surgery - What To Know?
The Anterior Cruciate Ligament (ACL) is one of the most important ligaments in the knee. Sportsmen have the highest risk of ACL injuries. As the ACL is stretched while making sudden turns, running or jumping, it may get damaged or even tear. The A...
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Popular Questions & Answers

Acl ligament is absent in my right leg, adn due to overcompensation, my left leg is having knee problems, relieved by esgipyrin, but only for a few hours. Also, both legs are taking a bow shape due to my weight gain and sedentary work. Can bow legs by this phenomenon be corrected, and please suggest something for my left leg.

MBBS, MS - Orthopaedics
Orthopedist, Mumbai
If acl is absent that is grade 4 injury, you should get arthroscopic acl reconstruction surgery immediately. Delayed in surgery will push your knee towards arthritis, which will be a bigger problem and needing knee replacement. Go to your nearest ...
2 people found this helpful

A month ago I underwent arthroscopy for ACL Ganglion cyst removal from my left knee. Post surgery my left knee is still week and is recovering & because of which most of my body pressure is on my right knee, I have started feeling pain on my right knee too. Any suggestions on how should I handle this, I am afraid that this may cause problems on my good knee too. Thanks.

MBBS Bachelor of Medicine and Bachelor of Surgery, MS - Orthopedics, Fellowship, Depuy Joint Replacement
Orthopedist, Bhubaneswar
Only do knee muscle strength ig exercises ,quad strengthening ,hamstring strengthening ,theraband and static cycling for a long time till this problem subsides. Consult a physio and take medicines for present pain.

Hi, I am 34 years old. I have ligament injury of ACL. In MRI complete tear of acl at femoral attachment. My weight is 80 kg n height is 5.6. So what is treatment? Should I have do surgery?

MBBS, MS - Orthopaedics, Ozone Therapy
Orthopedist, Ghaziabad
Hi ,Lybrate user according to your age Arthroscopic ACL Reconstruction Surgery is treatment of choice consult A orthopedic surgeon nearby and go for it.

I had ACL reconstruction surgery one week ago my doubt is is it permissible to shake the leg and to walk and to journey.

MS - Orthopaedics
Orthopedist, Surat
Kindly consult your operating doctor for your querry. Shaking leg is not allowed and Walking is also not allowed. So it is better to avoid journey also as it may give rise to swelling.
1 person found this helpful

I have ACL tear since 2016, I done MRI AND Dr. from Medica hospital advised me for proper physiotherapy and I done it properly but now 2018 I face the same twisting problem in my right leg. So what I will do?

Erasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPT
Physiotherapist, Chennai
ACL Knee Ligament laxity if you have problem in your legs then it might be due to ligament laxity where your legs would become very weak due to the old ligament injury and that should be treated immediately. Wear knee cap so that you will feel fir...

Table of Content

What is the treatment?
How is the treatment done?
Who is eligible for the treatment? (When is the treatment done?)
Who is not eligible for the treatment?
Are there any side effects?
What are the post-treatment guidelines?
How long does it take to recover?
What is the price of the treatment in India?
Are the results of the treatment permanent?
What are the alternatives to the treatment?
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