KNEE LIGAMENT ACL RECONSTRUCTION

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Orthopaedics

ABOUT ARTHROSCOPIC LIGAMENT REPAIR (ACL/PCL)

Arthroscopic surgery is done through small incision in the skin to repair injured ligament, tissue, cartilage, etc in the joint area. The surgery is conducted with the aid of an arthroscope, which is a very small instrument guided by a lighted scope attached to a television monitor. Other instruments are inserted through three incisions around the knee.

Ligaments of knee joint include Anterior cruciate ligament(ACL), Posterior cruciate ligament (PCL), Medial collateral ligament (MCL), Lateral collateral ligament(LCL) and their injury/tear can result in knee instability, severe knee dislocations, and complete lack of knee mobility.

Depending on the grade of injury, patient may be advised surgery in form of repair or reconstruction of the ligament.

DURATION

It usually takes less than 2 hours to complete the procedure. Commonly done as daycare surgery, may require short hospital stay of 1-2 days.

RECOVERY

Initially there maybe pain, immobility and inflexibility, bracing of the leg, crutch dependence, with increasing mobility and flexibility with rehabilitation. Physical therapy is started immediately after the surgery. Full recovery can take up to three months.

RISKS

- Infection
- Bleeding
- Damage to nerves/blood vessels
- Instability
- Numbness

PROCEDURE

Arthroscopic surgery can be performed under local, regional, or general anaesthetic.

Through a small incision around the knee, lighted arthroscope is inserted, allowing to visualize the area under magnification, on a television monitor. Instruments to perform the surgery are put through other incisions in the area.

ACL is a large ligament that keeps the knee from hyperextension or being displaced back from the femur. Instead of repair, it is generally replaced by a substitute graft made of tendon. Graft is prepared using tissue from the patient, called an autograft, or from a cadaver, called an allograft. ACL reconstructive surgery involves drilling a tunnel into the tibia and the femur. The graft is then pushed through the tunnels and secured by stapling or sutures.

PCL is a back-crossing ligament that attaches the front of the femur to back of the tibia behind the knee and keeps the knee from hyperextension or being displaced backward. Surgery involves reattaching the PCL to the bone.