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We’ve all heard about it, but what is ACL surgery? ACL surgery full form is anterior cruciate ligament surgery. It is performed when individuals suffer ACL injuries whilst taking part in sports or meeting with accidents. ACL surgery, also known as ACL reconstruction, helps rebuild torn ligaments and restore movement in the injured knee.
Synopsis
- What is the ACL & Why is it Important?
- Causes & Symptoms Leading to ACL Surgery
- What is ACL Reconstruction Surgery?
- What are the Benefits of ACL Reconstruction Surgery?
- How is ACL Surgery Performed?
- ACL Surgery Recovery Time & Post-op Care
- Long-Term Outcomes & Considerations
- Cost of ACL Surgery in India
- Popular Cases
What is the ACL & Why is it Important?
ACL is 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 movements. When the ACL in the knee sustains an injury, it 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. In such cases, an ACL knee surgery, also known as ACL ligament surgery, may be recommended.
Causes & Symptoms Leading to ACL Surgery
ACL injuries may occur during non-contact activities that involve landing awkwardly from a jump or sudden twisting of the knee while changing direction. They may also result from contact sports, particularly when there is direct impact on the knee or hyperextension of the joint. Symptoms of an ACL injury typically include a popping sound at the time of injury, followed by severe pain, rapid swelling, limited range of motion and knee instability. To restore knee function, an ACL injury surgery or ACL tear surgery may be performed, depending on whether the ligament has sustained a sprain, partial tear, or complete rupture. Recovery is gradual and may take around 6 months to a year. While some degree of bruising, swelling and stiffness is normal in the early weeks, certain bad signs after ACL surgery should not be ignored. These include excessive pain and swelling that do not improve, fever, redness, warmth or pus at the surgical site, and loss of sensation or movement. In such cases, it is essential to contact the surgeon immediately.
What is ACL Reconstruction Surgery?
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 have a faster recovery. Most individuals who suffer traumatic knee injuries often simultaneously injure not only the ACL but also the meniscus—a C-shaped cartilage that cushions and stabilises the joint between the thighbone and shinbone. In such cases, ACL and meniscus surgery are typically performed together.
What are the Benefits of ACL Reconstruction Surgery?
The benefits of a 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. Visit Manipal Hospital Old Airport Road—the top orthopaedic hospital in Bangalore for ACL Reconstruction Surgery.
How is ACL Surgery Performed?
Arthroscopic ACL ligament surgery 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 the 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 the screwless technique, a graft is fixed with a small button in the thigh and fixed in the leg without a screw.
Some cases that involve partial tears or mild sprains can be managed with ACL tear treatment without surgery. This includes physiotherapy, bracing, and avoiding strenuous or high-impact activities during the recovery period.
ACL Surgery Recovery Time & Post-op Care
ACL surgery recovery time often varies depending on the age of the individual, as well as the severity of their injury and type of surgery they have undergone. The first week after ACL surgery signifies the early healing phase, when the knee may still be swollen and stiff. Using crutches for support, managing inflammation carefully, and beginning gentle rehabilitation exercises during this stage is crucial for a smoother recovery. Exercises after ACL recovery vary depending on the phase of recovery and are essential for restoring strength, motion and stability.
Unlike conventional techniques, the screwless technique enables faster recovery with minimal complications. According to Dr Mallinath, this technique does not show any reaction related to bioabsorbable screws. Recovery after ACL surgery is faster and the knee is more stable. Patients can walk on the same day, drive a car after 15 days and a two-wheeler after four weeks.
Long-Term Outcomes & Considerations
ACL surgery generally offers good long-term outcomes in terms of knee stability. Individuals can often go back to their regular activities and play sports. However, despite successful surgery, some people do develop osteoarthritis or complications such as infection, graft failure and persistent pain or stiffness later in life.
On the other hand, choosing not to undergo ACL surgery may carry higher risks. The long-term effects of an ACL tear without surgery include persistent knee instability, increased risk of further injuries, and a greater likelihood of developing osteoarthritis.
Cost of ACL Surgery in India
ACL surgery cost generally varies depending on a number of factors, including the type of surgery, the hospital where it is performed, the surgeon’s expertise and the location. The average ACL surgery cost in India, particularly for ACL reconstruction, generally ranges from around ₹150,000 to ₹350,000, and ACL tear surgery cost typically falls between ₹70,000 and ₹350,000. On the other hand, the screwless technique is considerably cheaper and brings down the overall cost of ACL surgery by ₹10,000 to ₹15,000, making it a more affordable option for patients.
Popular Cases
Many well-known individuals have suffered ACL injuries in the past, among which the Mark Zuckerberg ACL surgery case is one of the most notable. Zuckerberg’s ACL injury occurred during an MMA training session in November 2023, for which he underwent reconstruction surgery. His recovery progress was evident, as he was spotted surfing in August 2024, six months post-surgery.
To ensure the best long-term outcome, ACL injuries should be addressed and treated promptly. Dr. Mallinath, who has performed more than 700 arthroscopic ACL reconstruction surgeries in the last 10 years and more than 100 screwless arthroscopic ACL reconstruction surgeries in the last three years, has been regarded as the top orthopaedic doctor in Bangalore.
FAQ's
It is generally not advisable to delay an ACL surgery. Without a stable ACL, the risk of your knee giving way usually increases the risk of injury to other areas, including cartilage or meniscus. Whenever possible, arranging early consultation with your physician is the way to avoid continued joint issues in the future.
Many people can start walking with crutches or a brace within a few days after surgery, depending on the type of repair and your doctor’s advice. Full weight-bearing without support may take 2 to 6 weeks. Early, guided movement is encouraged to keep your knee flexible and strong.
Yes, most patients are able to return to sports. But, the timeframe to return is always after a full recovery, which is usually 6 -12 months. Returning to sports too early can raise a higher risk of re-injury.
Unfortunately, there is a small risk of developing further arthritis in your knee over time, even after a successful surgery. But your surgery will help reduce the risk by stabilizing your knee joint and preventing future damage.
Both options are equally effective. When using your own tendon (autograft) you generally have faster healing times, and a lower potential of rejection; this is typically more of a concern for younger and more active people. Donor grafts (allografts) are generally less invasive and are often a better option for older adults or those with less physical activity. Your surgeon will recommend which option best fits your life, activity and goal
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