Anterior Cruciate Ligament (ACL) Surgery
MEDICAL ANIMATION TRANSCRIPT: The anterior cruciate ligament, or ACL, is one of the four main ligaments connecting the femur to the tibia. The ACL provides stability as you move your knee. A torn ACL may occur if your a knee joint over-rotates, or if you receive a direct blow to the front of your knee. If your ACL tears through completely, your doctor may recommend surgery to repair it. Before your procedure, you will receive either spinal anesthesia, which will numb your body from the chest down, or general anesthesia, which will put you to sleep for the duration of the procedure. During this arthroscopic procedure, your surgeon will make a few incisions around your knee, through which he or she will insert surgical instruments including a camera. The camera will transmit images to a TV monitor, which the surgeon will view during the procedure. First, your surgeon will remove the remaining portions of your torn ACL from your knee. Then, your surgeon will remove part of your patellar tendon to use as the graft, or obtain donor tissue. Your surgeon will create attachment points for the graft by drilling a small tunnel in the end of your tibia, then another at the end of your femur. Your surgeon will place one end of the patellar tendon graft in the tibial tunnel. Then, he or she will pull the graft up through the knee joint and into the femoral tunnel to create a new ACL tendon. Finally, your surgeon will place small screws in the tunnels at either end of the new ACL to hold it in place. Over the next six to eight weeks, bone growth will fill in these tunnels, further stabilizing the graft. At the end of the procedure, your doctor will remove the instruments and close the incisions. This procedure typically lasts two to two and 1/2 hours. After the procedure, you will go to the recovery room for two to three hours, and then go home. You will likely need a knee brace and crutches for one to four weeks. Supervised physical therapy should begin two or three days after surgery, and continue for 6 to 10 weeks. After this time, continue with self-directed therapy as long as needed. It takes about nine months for a reconstructed ACL to fully heal. You should avoid contact sports, racquet sports and other sports that require rapid direction changes until you obtain approval from your physician.