Advances in ACL reconstruction surgery employ sophisticated techniques that are less invasive to the patient and offer the added benefit of faster recovery times than ever before.
WHAT IS ACL Reconstruction Surgery?
ACL (anterior cruciate ligament) reconstruction is a surgical procedure to repair a torn ligament in the knee. During the procedure a surgeon prepares a tendon graft taken either from the patient’s own body (autograft) or from a deceased person (allograft), who has donated parts or all of his/her body to medical science.
The term ACL reconstruction is used because past experience has shown that repairs to the damaged ligature are not effective. The damaged ACL ligament cannot simply be sewn back together. Repairs are not an option – the damaged ACL must be replaced.
How is ACL Reconstruction Surgery Performed?
While ACL reconstruction is still considered major surgery, it is increasingly performed on an outpatient basis under a local anaesthetic.
For some patients with severe damage to multiple ligaments in the knee, the surgeon may elect to do open surgery, under a general anaesthetic. In open surgery the knee is opened up completely so that the surgeon may better assess the damage.
Currently, healthy tissue is usually harvested from the middle third of the patella tendon. Many surgeons prefer to use a bone-to-bone (BTB) tendon graft. In lay terms, this means that the surgeon harvests a strip of new tissue with a small plug of bone attached at either end. Small holes are then drilled in the femur and tibia allowing the new tendon to be attached. When the surgery is successful, the bones and implant bone plugs knit together, providing greater strength and stability to the knee joint. This is the preferred method, or “gold standard” procedure. However, each surgeon will have his/her own preferred methods and techniques.
Pros and Cons to ACL Reconstruction
ACL reconstruction is major surgery. It is elective surgery; meaning that the patient, in consultation with the surgeon, decides whether or not to proceed with the operation. As with any other surgery there are risks and benefits.
Seven Benefits of ACL Reconstruction:
- Surgery is often done under a local anaesthetic resulting in shorter wait times, less trauma and faster recovery.
- Success rate ranges from 82% to 95%
- The patient may regain full range of movement and be able to return to previous levels of activity.
- Prevent further tissue damage to the ACL.
- Help to prevent early onset arthritis.
- Provide relief from intense pain and swelling.
- With the outpatient procedure there is less scarring and faster recovery
Nine Risks of ACL Reconstruction:
- There is a risk of infection, however slight.
- Risk of patellar (kneecap) fracture.
- Some patients report constant pain post-operatively, particularly when kneeling
- Donor grafts tend to be less strong than grafts taken from the patients’ own body.
- Donor grafts carry some risk of disease transmission.
- Lengthy recovery time – six to nine months.
- Rehabilitation therapy is intensive and can be painful.
- Costs may not be covered by insurance
- Procedure not suitable for young people who are still growing.
Each patient must weigh the benefits and disadvantages for him/herself. For many, the promise of enhanced quality of life outweighs the disadvantages.