An Anterior Cruciate Ligament or ACL tear is a common knee injury, particularly in very active people and athletes. It can cause pain, swelling, and instability in the knee, making many normal day-to-day activities difficult. Depending on the severity of the tear, ACL reconstruction surgery may be required to successfully repair the damage.
The Anterior Cruciate Ligament (ACL)
The knee is made up of three bones – the femur (thighbone), the patella (kneecap), and the tibia (the larger lower leg bone). Muscles in the thigh give the knee strength and stability and allow a variety of movements. The anterior cruciate ligament (ACL) – a major ligament in the knee, is a strong band of tissue that connects the femur to the tibia. Along with the posterior cruciate ligament (PCL), they hold the bones inside the knee together to provide stability, motion, and flexibility while maintaining balance.
The ACL can stretch or tear when making a sudden movement, such as slowing down suddenly from running, landing from a jump, or changing direction rapidly. It is a common injury in sports such as football, basketball, skiing, and soccer. Symptoms can include pain, swelling, a popping noise at the time of injury, and knee instability immediately afterwards. Swelling can develop and increase dramatically within a few hours, and there may be difficulty when walking, moving, and straightening the knee.
In ACL reconstruction, the orthopedic surgeon removes the torn ligament and replaces it with a piece of healthy tendon, called a graft, usually taken from an area near the knee, or sometimes from a cadaver. The aim of surgery is to restore function and stability and to prevent further injury to the knee joint. Many ACL reconstructions are performed through minimally invasive arthroscopic procedures and can be carried out as an outpatient procedure.
A partial or complete ACL tear is unable to repair itself. It is also common to see damage to other surrounding knee structures when the ACL is injured. Some ACL injuries may be treated using non-surgical methods such as rest, elevation, immobilization, medication, and physical therapy. However, surgery may be recommended if:
- There is significant knee instability causing the knee to buckle during everyday activities
- The ACL tear is accompanied with other injuries
- An individual is active in sport, or a job with heavy manual work, who requires regular use of the knee.
Prior to surgery, most individuals participate in physical therapy to reduce pain, inflammation, and stiffness and to strengthen muscles and improve mobility and movement. Physical therapy before and after surgery can help reduce recovery time and ensure a successful recovery.
Most ACL reconstructions are performed as outpatient procedures meaning patients can often go home on the same day of surgery. A general anesthesia or nerve block to numb the knee and leg area is typically used during an ACL reconstruction. Many ACL reconstructions are performed using only small incisions around the knee joint to hold an arthroscope (a very small surgical instrument containing a lens and lighting system that allows the surgeon to see inside the joint) and to allow small surgical instruments access to the joint space. The arthroscope is attached to a miniature camera that allows the surgeon to view the magnified images on a video screen or take photographs and record the videotape.
During surgery, the surgeon will remove the damaged ligament and then attach the new graft using surgical hardware. The graft acts as scaffolding on which the new ligament tissue can grow. The surgeon will then test the new graft and knee function to ensure that the knee is stable and has full range of motion.
Recovery from ACL reconstruction can take time. The surgeon will provide specific instructions on how to control swelling and pain after surgery and rest, elevation and ice are very important to aid healing. Pain medication will also be required.
Progressive physical therapy will be required following surgery aiming to improve functional ability, strength, flexibility and movement. The physical therapist creates a rehabilitation plan which is important for proper healing and achieving the best possible outcomes. Successful ACL reconstruction combined with focused rehabilitation can usually restore stability and function to the knee and recovery generally takes about nine months. It may take 12 months or longer before athletes can return to their sports.
ACL Reconstruction Surgery in North Dakota
The knee is one of the most commonly injured joints in the body. If you have a knee problem, The Bone & Joint Center can help. We treat all types of knee conditions and injuries, including ACL tears. Our medical and surgical orthopedic practice is dedicated to providing general and specialized orthopedic care to patients in the Upper Midwest. If you would like more information about ligament reconstruction or about our other orthopedic services, please call our office at (800) 424-2663. We welcome your call!