ACL Reconstruction
Anterior cruciate ligament (ACL) reconstruction is designed to restore knee stability following an ACL injury. ACL reconstruction can help reduce pain, restore stability, and prevent further meniscal injury. It is important that adequate pre-habilitation has been completed prior to surgery. The initial swelling from injury should be fully resolved and a full range of movement restored before ACL Reconstruction is undertaken.
The Procedure
During ACL reconstruction, a graft is taken from either the hamstring tendons, quadriceps tendon or the patellar tendon to create a new ligament. The operation is usually performed using a keyhole approach, with a small camera used within the knee to facilitate the surgery. The procedure typically takes around 1 hours, but this can be longer if additional meniscal repairs are needed or the addition of a lateral extra-articular tenodesis in recommended. Most patients undergo general anaesthetic together with a Medial Adductor block and local anaesthetic to ensure good post-operative pain control.
The incisions are closed with absorbable sutures, and a dressing. Some patients may require a knee brace if meniscal repair was required. This is typically carried out as a day procedure. The physiotherapy team will ensure you are safely mobilised before home and a plan for your 12 month rehab program will be outlined. Ice is important to help reduce swelling in the early phase.
Recovery
The physiotherapy rehab program plays a crucial role in the recovery process. The initial early goals are to reduce the swelling and restore a full range of knee mobility as soon as possible. The next phase is muscle strengthening and coordination / balance training. This gradual approach allows the new ligament to heal without excessive load as it undergoes ligamentisation over the 12 months after surgery.
The recovery timeline for ACL reconstruction is approximately 12 months. The latter stages of this include a readiness to return to sport component. However this time frame is dependent on adequate progress with the rehabilitation. It may take some patients longer to progress to being ready for sport.
Follow-up appointments to monitor progress are: 2 weeks for wound check, 6 weeks Consultant clinic to check wounds are healed and the knee has a full range of movement, and 4-6 months to assess rehab progress and plan isokinetic testing.