ACL Reconstruction Doctor In Nashik

Anterior Cruciate Ligament (ACL) Recunstruction

What Is The ACL?

The Anterior Cruciate Ligament (ACL) is one of the major stabilising ligaments of the knee. It is a strong, rope like structure in the centre of the knee that helps to prevent the knee from slipping out of joint while performing sports and other activities that require pivoting or sudden changes in direction.

When this ligament is torn it does not heal, and this results in a feeling of instability, or giving way, when the individual attempts activities that require pivoting or sudden changes in direction. This giving way can result in further damage to other structures within the knee joint such as the meniscus or articular cartilage.

ACL reconstruction is a commonly performed surgical procedure to create a new ACL to replace the damaged ligament. With recent advances in arthroscopic techniques it can now be performed with a high level of success, minimal incisions, and low complication rates.

How Do You Know It's Torn?

Typically the injury occurs with a twisting movement or sudden change in direction, and is accompanied by a painful "pop" and/or sensation of the knee giving way. Generally the patient is unable to continue playing at the time of the injury. The knee frequently swells, often within a few hours, and there is a sensation that the knee is unstable or weak.

Diagnosis

An ACL tear can usually be diagnosed by taking a detailed history of the injury and performing a thorough physical exam. Knee instability can be detected by a skilled examiner by applying specific stresses to the joint.

An Xray will rule out fractures or dislocations, and an MRI will confirm the exact nature of the ligament tear and reveal any associated damage to the cartilage or meniscus within the knee.

Treatment

Initial treatment consists of simple steps to limit further damage to the knee which includes

  • Rest
  • Ice
  • Compression
  • Elevation

The surgery is planned when swelling and pain has resolved and the range of motion has resolved.This will make recovery from surgery much easier and reduce the risk of complications. Physical therapy may be recommended prior to surgery in case of knee stiffness.

Earlier surgery may be required if the knee gets locked do to cartilage tear.

The aim of surgery is to return the knee to its normal motion, and to prevent it from slipping or giving way. This is to allow the individual to participate in all their normal sporting activities (including those at the highest level), and to avoid further damage to other structures within the knee that can occur with repeated giving way.

The ACL surgery

Improvement in surgical techniques for ACL reconstruction in the past 10 years have resulted in surgery that is more successful, less painful, and with shorter recovery times than in the past.

The majority of the surgery is performed arthroscopically (“key hole”) using specialized instruments to access the centre of the knee. Firstly a small incision is made adjacent to the knee to identify the hamstring tendons which will be fashioned into the ligament graft that will be used to reconstruct the damaged ACL. Occasionally the central part of the patella tendon at the front of the knee may be utilized instead. Tunnels are drilled in the femur and tibia where the old ACL was attached and the replacement graft is then pulled through these tunnels and attached to the bone at each end.  Depending on the type of graft, it may be attached using screws, staples or other fixation devices. These act to hold the graft solidly whilst it heals into the tunnels.

At the time of the surgery the arthroscope allows the entire knee to be clearly visualized, and any other damage, such as cartilage or meniscus tears will also be repaired at the same time.

Post-operation

Surgery is performed either as a day only procedure, or with a single overnight stay. Crutches are used for the first 7-10 days in order to help regain normal walking pattern at the fastest possible rate. Physiotherapy is started few days after surgery and continued for between 3 and 6 months after surgery.

Summary

Anterior Cruciate Ligament reconstruction is a common and successful procedure which can return the majority of patients with this injury to full activity. Success is a combination of precise surgical technique and appropriate rehabilitation, and in the hands of an experienced surgeon the vast majority of patients can expect an excellent outcome.

The above information gives an overview of the common issues relating to this procedure. It is aimed at educating you about what is involved in ACL reconstruction. If you have any further questions please consult Dr. Kunal Dhurve.

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