A torn meniscus will cause knee pain and, sometimes, swelling. More importantly, however, a damaged meniscus increases a patient's risk of developing osteoarthritis of the knee later in life.
For a complete tear of the ACL, reconstruction surgery is generally scheduled for between three and six weeks after the injury occurs. This allows inflammation in the area to subside. If surgery is performed too early, patients may develop a profound scarring response called arthrofibrosis.
Some evidence suggests that delaying ACL reconstruction surgery for six months or longer after injury reduces a person's chances of having a clinically significant outcome and leads to increased rates of the need for future revision surgeries.
ACL reconstruction surgery is performed using minimally invasive arthroscopic techniques, in which a combination of fiber optics, small incisions and small instruments are used.
A somewhat larger incision is needed, however, to obtain the tissue graft. ACL reconstruction is an outpatient ambulatory procedure, in which patients can go home on the same day as their surgery. It usually takes six to nine months for a patient to return to participating in sports after an ACL reconstruction, depending on the level of competition and the type of activity. Patients are able to walk with crutches and a leg brace on the day of surgery.
Very soon after surgery, the patient enters a rehabilitation program to restore strength, stability and range of motion to the knee. The rehabilitation process is composed of a progression of exercises:. The degree of pain associated with ACL recovery varies and can be addressed successfully with medication.
Recovery time also varies from patient to patient. The determination of when a patient has fully recovered is based on the restoration of muscle strength, range of motion and proprioception of the knee joint. Arthroscopic surgical techniques have made recovery times quicker and easier in comparison to open surgery, which is how ACL reconstruction performed in the past.
But to achieve a successful outcome, it is critical that the patient have a rehabilitation period that is carefully supervised by an appropriate physical therapist, as well as to have follow-up appointments with the surgeon. In most cases, it is not possible to repair or reattach a torn ACL. ACL surgery usually involves a complete rebuilding of the ligament. Choosing the right surgical option for an ACL tear from the start can have lifelong implications, and it is critical to get ACL surgery right the first time.
This procedure typically uses a graft, or a piece of tissue, placed in the knee in a minimally invasive surgery that uses small incisions. ACL repair is an older technique that involved sewing the torn ACL tissue back together with sutures, rather than rebuilding it with a graft. Today, ACL repair has been modernized and can be performed through a minimally invasive approach. Treatment of Knee Hyperextension.
Treatment of Dislocated Kneecaps. Soft Tissue of the Knee Joint. You are here Sports Injuries Knee Injuries. Peer Reviewed. The main goal of the surgery is to restore stability to the injured knee. While there is no age cut-off for surgical intervention, it is rarely performed on individuals over age Activity level.
Surgical reconstruction may also benefit young people and those who participate in occupations or sports that involve jumping, pivoting, cutting, or rapid deceleration. Associated injuries. Patients with multiple knee injuries ACL plus meniscus, fracture, or medial collateral ligament generally benefit from surgery to prevent significant activity restrictions and minimize the risk of developing knee osteoarthritis.
Paschos NK. Anterior cruciate ligament reconstruction and knee osteoarthritis. World J Orthop. Published Mar Bench-to-bedside: Bridge-enhanced anterior cruciate ligament repair. J Orthop Res. Epub Jul 9. Appl Bionics Biomech. Blahd Jr. Fu MD - Orthopedic Surgery. Author: Healthwise Staff. Medical Review: William H. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use and Privacy Policy.
Learn how we develop our content. To learn more about Healthwise, visit Healthwise. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Top of the page. ACL reconstruction surgery uses a graft to replace the ligament. The most common grafts are autografts using part of your own body, such as the tendon of the kneecap patellar tendon or one of the hamstring tendons.
Sometimes the quadriceps tendon from above the kneecap is used. Another choice is allograft tissue, which is taken from a deceased donor. Repair surgery typically is used only in the case of an avulsion fracture a separation of the ligament and a piece of the bone from the rest of the bone. In this case, the bone fragment connected to the ACL is reattached to the bone. Arthroscopic surgery Many orthopedic surgeons use arthroscopic surgery rather than open surgery for ACL injuries because: It is easy to see and work on the knee structures.
It uses smaller incisions than open surgery. It can be done at the same time as diagnostic arthroscopy using arthroscopy to find out about the injury or damage to the knee. It may have fewer risks than open surgery.
What happens During arthroscopic ACL reconstruction, the surgeon makes several small incisions—usually two or three—around the knee. What To Expect Arthroscopic surgery is often done on an outpatient basis, which means that you do not spend a night in the hospital. Why It Is Done The goal of ACL surgery is to restore normal or almost normal stability in the knee and the level of function you had before the knee injury, limit loss of function in the knee, and prevent injury or degeneration to other knee structures.
You may choose to have surgery if you: Have completely torn your ACL or have a partial tear and your knee is very unstable. Have gone through a rehab program and your knee is still unstable.
Are very active in sports or have a job that requires knee strength and stability such as construction work , and you want your knee to be as strong and stable as it was before your injury. Are willing to complete a long and rigorous rehab program.
Have chronic ACL deficiency, which is when your knee is unstable and affecting your quality of life. Have injured other parts of your knee, such as the cartilage or meniscus , or other knee ligaments or tendons.
You may choose not to have surgery if you: Have a minor tear in your ACL a tear that can heal with rest and rehab. Are not very active in sports and your work does not require a stable knee. Are willing to stop doing activities that require a stable knee or stop doing them at the same level of intensity. You may choose to substitute other activities that don't require a stable knee, such as cycling or swimming.
Can complete a rehab program that stabilizes your knee and strengthens your leg muscles to reduce the chances that you will injure your knee again and are willing to live with a small amount of knee instability. Do not feel motivated to complete the long and rigorous rehab program necessary after surgery.
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