ACL reconstruction is surgery to replace a torn anterior cruciate ligament (ACL) — one of the major ligaments in your knee. ACL injuries most commonly occur during sports that involve sudden stops and changes in direction — such as basketball, cricket, soccer, football, tennis, downhill skiing, volleyball and gymnastics.
In an ACL reconstruction, the torn ligament is removed and replaced with a piece of tendon from another part of your knee. This surgery is through small incisions around your knee joint.
Ligaments are strong bands of tissue that connect one bone to another. The ACL, one of two ligaments that cross in the middle of the knee, connects your thighbone (femur) to your shinbone (tibia) and helps stabilize your knee joint.
- Suddenly slowing down and changing direction (cutting)
- Pivoting with your foot firmly planted
- Landing from a jump incorrectly
- Stopping suddenly
- Receiving a direct blow to the knee
A course of physical therapy may successfully treat an ACL injury for individuals who are relatively inactive, engage in moderate exercise and recreational activities, or play sports that put less stress on the knees.
- You’re an athlete and want to continue in your sport, especially if the sport involves jumping, cutting or pivoting
- More than one ligament or the cartilage in your knee is injured
- You’re young and active
- The injury is causing your knee to buckle during everyday activities
- Knee pain, stiffness or weakness
- Poor healing of the graft
- Failure to achieve symptom relief
How long will I be in the hospital?
Typically ACL surgery is an ambulatory surgery – you go home by 2nd day of the surgery.
What type of anaesthesia will I need?
Typically ACL surgery is performed with a spinal anaesthesia at Hospital. You will be sedated and can sleep through the operation. General anaesthesia is usually not necessary.
Will I need crutches and a brace after the surgery?
Patients go home with crutches and a brace. If your meniscus does not need to be repaired, I typically remove the brace when I see you for your first follow up 10-14 days after the surgery. I recommend that you use the crutches until you can walk without a limp. This usually takes approximately 1 month from the time of surgery. In some cases, crutches are needed for longer periods of time to protect repaired tissue such as in the setting of a meniscus repair.
When can I return to sports?
I typically allow return to sports 9 months after the operation.
When can I shower?
I do not like your stitches to get wet. Therefore, you may shower when you get home, but the incision will need to be covered. I recommend using plastic wrap around the area to prevent it from getting wet. The stitches will be removed at the follow up appointment 14 days after the surgery; thereafter, it is safe to get the incision wet.
How long should I use the pain medication?
This is different for each patient; A general rule is that you should try to decrease your use of these medications as time passes.
Whencan I drive?
You should not drive as long as you are taking narcotic pain medication, usually allow driving 4-6 weeks after surgery.
I feel “clicking” inside the knee, is this normal?
The clicking is a result of the soft tissue moving across the joint. This sensation usually diminishes as your muscles get stronger.
When can I return to work?
It depends on your occupation. It is never a mistake to take more time off in the beginning of your recovery, as it will give you time to focus on your surgery. I recommend taking at least 7 days off of work after ACL surgery if you have a sedentary job. If you are on your feet, you may need 4-6 weeks or more before you are ready to return to work.
When can I go to the dentist?
Please wait until 6 weeks after surgery, as the joint is still healing and there is increased blood flow to this area.
When Can I travel?
In general, I like to see you before you fly. If you are travelling by car, you should be sure to take frequent breaks so that you don’t feel too stiff when getting up. On an airplane, I like you to take a couple of walks during the flight. Having an aisle and bulkhead seat will help you get more space.
I notice an area of numbness around my knee – is this normal?
You may notice a small area of numbness on the outside area of the knee incision. This may or may not resolve over time.
My knee still feels stiff 6 weeks after the operation – is this normal?
Surgical healing usually takes 6-8 weeks. However, the tissues remain swollen which can cause discomfort for some time. Over time, the knee tissues begin to soften and become more natural.
Is there a better time of year to have the surgery?
This is a personal decision; some patients like to have the surgery in good weather so that they may walk outdoors as part of their recovery.
My knee is really swollen, does it need to be aspirated?
Fluid can accumulate in the legs due to the effect of gravity. To combat this, you should elevate your legs at night by lying on your back and placing pillows under the legs so that they are above your heart.
Very few patients require aspiration (drainage of fluid from the knee) following ACL surgery. A few patients have excessive swelling and the area above the knee becomes tense and hard. If this happens to your knee, we will discuss the risks and benefits with you and we will decide together if your knee needs to be aspirated.