We’ve all heard about it, but what is an ACL? ACL is an anterior cruciate ligament, a band of fibrous tissue that joins thigh and shin bones together at the knee joint. It helps to stabilise the knee joint in performing front to back and twisting movement.
ACL knee injuries can happen whilst taking part in sports or accidents. An ACL injury may stop a person from doing normal activities or sports as the knee loses its full range of motion, becoming unstable and painful. The knee may give way or it may feel like it is giving way. ACL repair surgery, known as ACL reconstruction, may then be recommended to rebuild torn ligament.
The benefits of successful reconstruction ACL surgery are that the knee will be stabilised and therefore not give way anymore. This surgery aims to relieve pain and allow a person to be more active and return to playing some or all sports such as football, rugby, netball or skiing. It also reduces the risk of a further knee injury.
ACL reconstruction surgery is usually performed as a keyhole procedure so that it is less invasive than if it were performed using open surgery. This means patients benefit from less pain, minimise the risk of infection and a faster recovery.
Arthroscopic ACL reconstruction is carried out under a general anaesthetic or a spinal anaesthetic and typically takes about an hour. Surgeons will then make small cuts in the skin over the knee and insert a thin, flexible tube with a light and camera on the end of it, known as an arthroscope, to see inside the knee.
The remnants of torn ACL are removed and replaced using a graft usually taken from the patellar tendon or hamstring. Sometimes a graft from a donor will be used.
The replacement ligament graft is fixed into place with special screws titanium or bioabsorbable screws drilled into holes in bones. In screw, less technique graft is fixed with a small button in the thigh and fixed in the leg without a screw. Dr Mallinath says with this technique we are not seeing any reaction related to bioabsorbable screws. Recovery is faster and the knee is more stable. Patients can walk on the same day, drive a car after 15days and a two-wheeler after four weeks. The cost of surgery comes down by 10000 to 15000 by this technique. Dr Mallinath has done more than 700 arthroscopic ACL reconstruction surgery in the last 10yrs and more than 100 screwless arthroscopic ACL reconstruction surgery in the last three years.
Sr. Consultant Orthopaedics, Arthroscopy and Joint Replacement Surgeon
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