How Is ACL Reconstruction Surgery Done?
ACL injuries are most common among athletes. Intense accidents during sports like basketball, soccer and football often lead to the complete tear of the ACL. For such damage, ACL reconstruction surgery is the only solution.
To learn about the Anterior Cruciate Ligament and the surgery in detail, read this article.
Anterior Cruciate Ligament & Causes of ACL Injuries
ACL or Anterior Cruciate Ligament is a vital part of the knee. It is one of the four knee ligaments. A ligament is a connective tissue that binds one bone to another, stabilising the joint.
Sudden twisting or turning leads to ACL injuries. When the ACL is completely torn, it cannot be treated with medicines, therapies and non-surgical options. In that case, ACL reconstruction surgery becomes the only option to restore the damaged knee’s function.
Grades
ACL injuries are divided into three grades or types. These divisions are based on the severity of the injury.
Grade 1:
When the ACL has been stretched or pulled beyond its capacity, it is usually termed a Grade 1 ACL injury or Grade 1 Sprain.
Grade 2:
When a ligament gets stretched so much that it partially tears, it is a Grade 2 injury or sprain.
Grade 3:
A near complete or complete tear of the ligament into two is termed a Grade 3 sprain.
While Grade 1 sprain can be treated with medications and therapies, the other two grades require surgical interventions.
Types
There are two types of ACL reconstruction surgery:
- Arthroscopic
- Open
Arthroscopic: When a completely torn ACL is reconstructed with the help of arthroscopy, it is called arthroscopic ACL reconstruction surgery. To learn about arthroscopy, go to the following section.
Open: The same surgery can also be done in a more invasive manner by making large incisions. This approach is called open surgery.
What Is Arthroscopy?
Arthroscopy is a keyhole or minimally invasive surgery.
During arthroscopy, a video camera, known as an arthroscope, is used. It is a pencil-thin instrument that allows the surgeon to see inside the joint without making large cuts.
Arthroscopy only involves making a few small holes through the joint.
If the arthroscopy is done for diagnosis, only an arthroscope is inserted in the joint. But, if it is for treatment, other instruments are also inserted along with an arthroscope. These other instruments are also thin and narrow like the arthroscopy itself.
Arthroscopic ACL Reconstruction Procedure
Typically, the ACL Reconstruction Surgery is performed with arthroscopy.
This procedure mainly involves the following steps.
Preparation:
Before the surgery, a couple of tests are conducted on the patient to rule out various conditions that can cause complications during surgery. Then, the patient is shifted to the operation theatre for the procedure.
Anaesthesia:
Anaesthesia is applied to the patient to make unconscious. The surgeon    and the anaesthetist will decide on the type of anaesthesia to be given to the patient.
Graft Placement:
When the ACL is completely damaged, the surgeon will remove it and place a graft in its place. A graft is a transplant or tissue taken from the patient’s body or from the donor’s body.
The graft is taken either from the patellar tendon or hamstring tendons.
Once the graft is prepared, a tunnel is created through the bones (the tibia and femur) with minimal cuts. Then, the graft is fixed in place through this tunnel. After the placement procedure is done, holes are closed with stitches.
After the surgery, the patient is shifted to the recovery room.
To learn about the cost of arthroscopic ACL reconstruction surgery, refer to the following link: ACL knee surgery cost in Delhi.
Anaesthesia Used During Reconstruction
There are three types of anaesthesia used before surgery.
General Anaesthesia:
Under GA, the patient becomes totally unconscious, in a situation like deep sleep.
Regional Anaesthesia: R
A only numbs some parts of the body. For example, a surgeon might only want to make you numb down the waist for knee surgery. So, the surgeon will prefer RA over GA.
Local Anaesthesia:
This type of anaesthesia only numbs the part that is to be operated. For ACL reconstruction, the surgery is normally done under General Anaesthesia. But, if the surgeon thinks fit, Regional Anaesthesia can also be used.
Benefits
A person with a completely damaged ACL has to face the following problems.
- Chronic knee pain
- The feeling of knee instability while walking or bearing weight
- Mobility issues
- Difficulty in walking
- Reduced activity
- Hampered social and work life
- Mental disturbances
Thus, the first and most important benefit of the surgery is that it helps one get rid of knee discomfort and mobility issues. As a result, all the secondary problems are also resolved like inactive life and mental issues.
Diagnosis
Before surgery, the doctor uses the following tests to examine the knee joint and learn about the extent of the injury.
- MRI
- CT Scan
MRI and CT scan both help examine knee ligament injuries in detail. But, MRI tests cannot be performed on a patient who has already got a metal implant inside.
In MRI, the imaging technique relies on magnetic energy that can interfere with metal implants. Thus, for such patients, a CT scan is the best alternative.
Prevention
ACL injuries are most common among athletes. To minimise the risk of these injuries, ensure the following points.
- Exercise regularly
- Ensure a healthy diet
- Wear protective gear before participating in a sports competition
- Follow all safety measures
- Don’t stop and change your direction suddenly while running (or avoid cutting); if not possible, learn the right technique to do it
- Don’t twist your leg with the foot firmly fixed on the ground (or avoid pivoting); if not possible, learn the right technique to do it
Conclusion
ACL reconstruction is often done with arthroscopy, which is a minimally invasive technique of surgery. With arthroscopy, a torn ligament is reconstructed through small holes.
The surgeon removes the damaged ACL and replaces it with a graft during the surgery. A graft is a transplanted tissue that is taken either from the body of the patient or any other person called the donor.
If the ligament needs surgery and arthroscopy might not offer effective treatment, a surgeon can also recommend open surgery.
To book your consultation with the best surgeon, visit the following link: Best arthroscopic surgeon in Delhi.
