ACL RECONSTRUCTION – PERTH
ACL Reconstruction – A patient’s guide:
Dr Arash Taheri
MBBS (Hons), BMedSci (Hons), FRACS (Orth)
Orthopaedic Surgeon
ACL Reconstruction Perth
ACL Reconstruction Surgery
The Anterior Cruciate Ligament (ACL) is one of the important ligaments that stabilises your knee joint.
Activities that involve running, swerving, pivoting or kicking rely heavily on the anterior cruciate ligament.
If you have injured or torn your anterior cruciate ligament, your knee can become unstable, collapse or ‘give way’ when making twisting or turning movements.
An ACL injury happens as a result of a twisting injury to your knee. The common causes are contact sports and skiing injuries.
You can injure other parts of your knee at the same time such as tearing a cartilage (meniscus) or damaging the joint surface.
If left untreated your knee joint may become more damaged over time. Depending on your circumstances, surgical ACL reconstruction may be an option to restore stability of your knee joint.
Why have an ACL Reconstruction
Dr Taheri may recommend ACL reconstruction surgery if in the long term ACL deficiency will lead to more injuries of the meniscus and more degeneration of the joint.
Ligaments are strong bands of tissue that attach one bone to another bone. During ACL reconstruction, the torn ligament is removed and replaced with a band of tissue that usually connects muscle to bone (tendon). The graft tendon is taken from another part of your knee.
ACL reconstruction is generally recommended if:
- You would like to continue sporting activities, especially if the sport involves running, jumping or pivoting
- More than one ligament in your knee is injured
- You have a torn meniscus that also requires repair
- The injury is causing your knee to buckle during everyday activities
- Age and other factors such as activity level and knee instability.
Graftlink All-Inside ACL Reconstruction
ACL Reconstruction Perth
Dr Taheri uses a technique called the “Graftlink All- Inside ACL” for Anterior Cruciate Ligament reconstructions.
The Graftlink All- Inside ACL technique has the following benefits:
- Minimally invasive – Limits soft-tissue dissection helps preserve bone and vascular connective tissue.
- Dual suspensory graft fixation
- Decreased bone removal
- Smaller skin incisions
- A decreased graft length.
There may also be decreased post operative pain associated this approach.
Recovery from ACL Reconstruction Surgery
Recovery times may vary from patient to patient for a number of reasons including age, current health, muscle and bone strength and commitment to rehabilitation amongst many other factors.
Surgery – The surgery itself usually takes around one hour and is usually done under general anaesthetic.
Post-surgery – You will stay over night after the surgery and be closely monitored. If all is well you will be able to go home the next day if cleared by the medical staff.
A friend or family member will need to pick you up from the hospital. You will probably feel a bit sleepy and might need some pain killers.
You will be given instructions on:
- Wearing a brace on your knee
- Warning signs to look out for
- Wound care and dressings
- Pain management
Physiotherapy recovery program – You will see a physiotherapist and be prescribed a rehabilitation program after your surgery. Prior to discharge you will be given exercise instructions and practice on how to best perform daily activities including climbing stairs, bathing, getting into and out of cars etc.
Hospital stay length – You will stay in hospital overnight after the surgery. It may be longer depending on your individual circumstances.
Movement after surgery – Moving around with crutches is recommended for the first 2-4 weeks for comfort, safety and confidence. The crutches can be discarded as soon as you are confident to do so and you are happy to weight bare on your knee.
Will I need time off work – Depending on occupation you may require a number of weeks off work and return to light duties. You can be driven in a car as a passenger immediately on discharge from hospital.
Everyday activities – It may take between 2-3 months to recover from surgery. This is dependant on a number of aspects including ongoing commitment to your rehabilitation program, age, current health, muscle and bone strength and other factors.
Driving – Patients may be able to drive a car approximately 6 weeks after surgery.
Patients MUST be able to perform an Emergency Stop and short car trips only are recommended initially. The decision to drive after surgery remains the responsibility of the patient.
Air travel – Air travel may be undertaken soon after you are cleared by Dr Taheri.
What Activities can I Return to After Rehabilitation?
What activities can you perform after ACL Reconstruction Surgery – Once recovered and rehabilitated, there are very few restrictions on activity after ACL Reconstruction surgery. You can participate in activities such as walking, cycling, skiing and tennis.
Running and impact sports – High impact pursuits such as running should not be performed for 6 months or more after surgery. Your suitability for returning to running activities depends on the nature and intensity of the sport you are undertaking.
Some activities may place the knee joint at risk (for example extremes of joint flexion and rotation in some advanced yoga postures) – if you are unsure please check with us prior to recommencing your desired activity.
Knee monitoring – Monitoring how your knee performs overtime is essential to your rehabilitation program. Follow up appointments will be scheduled in soon after surgery.
What are the Risks of ACL Reconstruction Surgery
ACL Reconstruction Surgery risks – ACL Reconstruction surgery is generally safe, and serious complications are uncommon.
Serious wound infection occurs in less than 1% of patients.
As with any major surgery, there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages.
It is important that you are informed of these risks before the surgery takes place. Complications can be medical (general) or local complications specific to the knee. Medical complications include those of the anaesthetic and your general well being. Almost any medical condition can occur so this list is not complete.
Complications that may include:
- Allergic reactions to medications
- Blood loss requiring transfusion – Low risk of disease transmission
- Heart attacks, strokes, kidney failure, pneumonia and bladder infections
- Complications such as infection or nerve damage
- Serious medical problems can lead to ongoing health concerns, prolonged hospitalisation or rarely death
Risk of Infection – Infection can occur with any operation. Infection rates are approximately 1 percent. If it occurs, it can be treated with antibiotics but may require further surgery.
Blood Clots (Deep Venous Thrombosis) – These may travel to the lung (Pulmonary embolism) and can occasionally be serious and even life threatening. If you get pain or shortness of breath at any stage, you should notify your surgeon.
Fractures or Breaks in the Bone – Fractures or breaks can occur during surgery or afterwards if you fall. To repair these, you may require surgery.
Wound Irritation or Breakdown – The operation may cut some skin nerves, so you will inevitably have some numbness and potential aching around the wound. This will not affect the function of your knee. Vitamin E cream and massaging can help reduce this. Occasionally, you can get reactions to the sutures or a wound breakdown that may require antibiotics or rarely, further surgery.
Damage to Nerves and Blood Vessels – Rarely these can be damaged at the time of surgery. If recognised they are repaired but a second operation may be required. Nerve damage can cause a loss of feeling or movement and can be permanent.
Pain relief – You will be given pain relief during your stay and either medication or prescriptions to go home with to keep you comfortable. Paracetamol and an anti-inflammatory (if tolerated) are the mainstays for pain relief.
Dr Taheri will discuss your concerns thoroughly prior to surgery.