Mr Sunil Kumar discusses ACL reconstruction

Skiing and snowboarding can be great fun – but it can also be tough on your knees.

Here Mr Sunil Kumar a Consultant Orthopaedic Surgeon and Knee Specialist at Spire Hartswood Hospital in Brentwood explains some of the injuries that he has dealt with from patients just back from the snowy slopes.

“One of the most common injuries I see from people back from skiing holidays is a rupture of the anterior cruciate ligament (ACL) which can be the result of a twisting injury to the knee.

“Unfortunately people suffering from such an injury may also find they have damaged other parts of the knee at the same time, tearing a cartilage or damaging the joint surface.

“Although it might be painful and inconvenient we can mend most of these injuries and many people return to the slopes after treatment – one skiing injury doesn’t always mean your skiing days are over.”

What is the ACL?

The anterior cruciate ligament is one of the important ligaments that stabilise your knee joint. If you have torn - or ‘ruptured’ - this ligament, the knee can collapse or give way when you make twisting or turning movements.

What are the benefits of surgery?

If your ACL reconstruction is successful, your knee should no longer give way. This will allow you to be more active and return to some or all of your sporting activities.

Are there any alternatives to surgery?

Physiotherapy can strengthen and help improve the co-ordination of the muscles in your thigh. In turn, this can often stop your knee giving way during everyday activities. Your knee, may, however remain vulnerable for more demanding/sporting activities involving twisting and turning. Wearing a knee brace may also help during sports activities.

What does the operation involve?

Your surgeon will make a few small cuts on the front and sides of your knee. This will normally be done through keyhole surgery using a camera to see inside the knee.

The surgeon will then replace the ACL with a piece of suitable tissue (a graft) from elsewhere in the body, most commonly the hamstring tendon or patella tendon. The top and bottom ends of the replacement ligament are fixed with special screws or anchors into ‘tunnels’ drilled in the bone.

A variety of anaesthetic techniques are possible. The operation usually takes between an hour and an hour and a half.

How soon will I recover?

You’ll usually be allowed home the same day, or the day after. Your surgeon may want you to wear a knee brace and crutches for a few weeks after the operation. Once your knee is settling down you will need to start physiotherapy which may run for as long as six months.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, get the advice of the healthcare team or your GP.

Going forward people should also bear in mind that there is always the chance that their knee is unlikely to be quite as good as it was before the injury. Accordingly it may be worthwhile considering altering their sporting activity in order to minimise the provocation and vulnerability.