Why get your ACL
The anterior cruciate ligament is one of the major ligaments in the knee. Located in the middle of the knee, the ACL prevents the shin bone from sliding out in front of the thigh bone.
Tearing your ACL is one of the most common knee ligament injuries, especially in sports and fitness activities that involve running, pivoting, turning and jumping.
Often a person tears his or her ACL not because of contact in a sport, but from rapidly slowing down or twisting. Football players and athletes in other contact sports often suffer from this injury.
Not everyone who tears the ligament has to have surgery. Some things to consider if you tear your ACL include whether you have persistent knee pain, your age and activity level, whether you're able to continue normal activities, whether more than one ligament is torn and whether you plan to continue activities that require a lot of jumping or pivoting.
What happens when you get your ACL
In the past, when someone tore his or her ACL, the surgeon would try to repair the ligament. Now, a new one is built. In the past, medical staff used synthetic materials to do this. Now, they use human tissue — either from a cadaver, or tissue from your own body, such as a portion of your patellar tendon or the hamstring tendons.
If the procedure is done by knee arthroscopy, the surgeon will make a small cut into your knee and insert a camera to review your ligaments and other tissue.
Next, the surgeon will make small cuts around your knee and insert medical instruments. The surgeon will repair any damage and remove the damaged ligament.
The surgeon will then attach the new ACL to your thighbone and shinbone, using screws or other medical devices.
Does it hurt?
After the surgery, your knee will probably be sore for up to three months, amid physical therapy.
With today's technology, the post-surgery pain is less than it used to be.
How long does it take
You will work with your doctor to determine how often and how long you should go to physical therapy. Physical therapy is vital to protecting your new ACL while it repairs. It can take as long as nine months for the graft, or the newly reconstructed ligament, to mature and heal.
One problem with ACL surgery is a lot of people jump back into activities and sports too quickly. At first, it might not cause pain to participate in sports a few months after the surgery. However, this is the period when the graft is prone to retearing or stretching. Protecting the graft is really important.
Your doctor might recommend you move the knee to prevent stiffness. It's important to listen to the post-surgery instructions.
You might need to wear a knee brace or use crutches for a week or more.
What are the risk
With most surgeries, there are risks associated with anesthesia, such as allergic reactions to medicines and breathing problems. And then there are risks associated with any surgery, like bleeding and infection.
Specifically with an ACL surgery, the risks include a blood clot in the leg, stiffness of the knee or lost range of motion, failure of the ligament to heal, failure of the surgery to relieve symptoms, injury to a nearby blood vessel, pain in the knee and weakness in the knee.
Also, there's an increased risk of retearing if you don't allow the new ligament to heal properly. This could occur if you participate in certain sports or activities too quickly after the surgery or if you don't follow your doctor's physical therapy recommendations.
Do you need follow-ups?
ACL injuries often occur in combination with other knee injuries, such as meniscus tears or other ligament tears. The surgeon might want to go in after the surgery and repair any other issues.