Anterior Cruciate Ligament or ACL is a minor repair or reconstruction surgery. The ACL is a crucial soft tissue that connects the femur in the knee to the tibia. Athletes experience a completely or partially torn ACL, which needs a less invasive surgery. Dr. Ronald Hess in West Chester is an orthopedic surgeon and ACL, reconstruction specialist.
How to Identify If ACL Surgery Is Needed?
Surgery decisions will depend on the ACL tear severity and the patient’s lifestyle. A completely torn ACL will not recover on its own, while partial ACL damage can recover without surgery.
To identify if the ACL tear is partial or complete the orthopedic surgeon in West Chester performs a couple of manual tests:
- Lachman test- The shin bone is tried to pull away from the thigh bone. The bones will not move at all or only a little if the ACL is partially torn.
- Pivot shift test- The patient is made to lie on his back. The surgeon lifts his legs and puts rotational pressure on his knee. In the case of the bone shifts, this test is positive.
Patients with partial tears are recommended to wait and see if the ligament heals on its own. In terms of lifestyle, if the athlete with complete ACL tears desires to maintain an active lifestyle will need surgery. Some old patients or those whose lifestyle is not associated with vigorous exercise will be recommended a non-surgical treatment plan. Such patients must never attempt rigorous exercise because with complete ACL tear they can tear meniscus [cartilage pad] causing swelling and knee pain. It increases their chances of developing knee osteoarthritis down the road.
How Soon to Get ACL Surgery?
ACL reconstruction surgery is scheduled after 5 to 6 weeks of injury. The proper time is based on:
- Other injuries that need initial treatment.
- The physical appearance of the knee.
- Patient’s pain level.
- Patient’s motion range and muscle control quality while bending or straightening the leg.
ACL Reconstruction Surgery Steps
- A small incision is made around the knee joint.
- The arthroscope is introduced inside the portal and saline solution is delivered for space expansion around the knee joint.
- The arthroscopic camera is inserted and the structure is evaluated on the monitor outside.
- If the doctor identifies lesions on soft tissues – meniscus & articular cartilage, it is fixed.
- Graft harvested from another body part of the patient is attached to bone plugs at each end. The graft gets its support from the plugs, which transforms into a new ACL.
- The new ACL is inserted inside the tibia and femur using a flexible guidewire.
- The bone plug is secured using screws. These plugs grow into surrounding bone over time.
- The surgical device is removed and the procedure is concluded.
It generally takes 6 to 9 months for a total recovery of ACT reconstruction surgery!