What is ACL reconstruction?
The cruciate ligament reconstruction involves replacing the torn anterior cruciate ligament of the knee with a graft. The graft is usually a section of tendon taken from another part of your knee, but sometimes it is from a donor or made from synthetic material. Your surgeon will choose the method most appropriate for you.
The operation is normally performed using arthroscopy (“keyhole” surgery). However a small number of people need surgery to open up the knee joint. Your surgeon will discuss which procedure is most suitable for you.
This summary sheet describes the keyhole method. This operation is typically performed under general anaesthesia, which means that you will be asleep during the procedure. ACL reconstruction usually involves at least one night’s stay in hospital. Your surgeon will explain the benefits of having an ACL reconstruction, and discuss the associated risks and alternatives to the procedure.
About the operation
A small incision (about 5mm long) is made in the skin over the knee that is being treated. Sterile fluid is put into the joint to help get a clearer picture. Another small incision is made for the arthroscope (a long, thin telescope). Your surgeon then looks into the joint, either directly through the arthroscope, or at pictures it sends to a video monitor.
Surgical instruments are inserted through further small cuts. The torn ligament is trimmed and the knee is prepared for the replacement graft. The graft is shaped, attached to the bones and fixed in place, usually with screws.
At the end of the knee reconstruction procedure the fluid is drained out of the joint. The incisions are closed with stitches or adhesive strips. The operation usually lasts one to two hours.
Afterwards, some pain, stiffness, swelling and bruising around your treated knee is to be expected. This is likely to last for some weeks, gradually improving as the knee heals.
ACL reconstruction is a commonly performed and generally safe operation. For most people, the benefits in terms of improved symptoms are much greater than the disadvantages. However, all surgery carries an element of risk.
Complications specific to cruciate ligament reconstruction include:
- infection of the wound or joint. Antibiotics are given during surgery to help prevent this
- a small risk of damage to nearby nerves or blood vessels. Nerve damage could result in altered sensation or loss of feeling in the skin over the knee
- over time, the graft may tear or stretch, or scar tissue may form around it. The screws that fix the graft in place may also come loose. In both cases, further surgery may be required
- if the replacement tendon graft is taken from your kneecap, there is a risk that the kneecap may be more susceptible to damage or fracture in the future
- for some people knee pain and function doesn't improve and further surgery may be required
The chance of complications depends on the exact type of operation you are having and other factors such as your general health. Ask your surgeon to explain in more detail how any risks apply to you.
To find out more about having knee reconstruction in a Spire Healthcare hospital, please call our treatment enquiry team on 0800 434 6600.
