ACL Reconstruction

ACL reconstruction is surgery to repair an injury to the anterior cruciate ligament or ACL. As one of the major ligaments in the knee, a tear to the ACL can result in severe pain and debilitation. Some less severe injuries may heal with rest and rehabilitation, while more severe tears might require surgical repair. The specialists at Orthopaedic Institute of Ohio offer a variety of treatment options for ACL injuries, including surgical reconstruction when necessary.

ACL Overview

The ACL is the ligament that extends from the shinbone to the thighbone, holding together the bones of the knee and keeping this critical joint stable. When the ligament becomes damaged, it can become difficult to put weight on the joint. Sudden stops or direction changes, such as those done by soccer, basketball and volleyball players, can lead to these injuries.

In the event of a complete ACL tear, surgery may be necessary. If the ligament is left to heal on its own, it may result in recurrent instability in the joint, which can feel like the knee is “giving out.” Some individuals find these symptoms restrict them from performing certain activities, which can significantly impact their quality of life.

What is ACL Reconstruction?

An ACL reconstruction is a surgery that repairs severe damage to the ACL. The procedure removes the torn ligament and replaces it with tissue from a donor. For young and active patients, ACL reconstruction is often the only method of ACL treatment that offers satisfactory results.

Is ACL Reconstruction Right for You?

While ACL reconstruction offers substantial benefits in the right patient, it is not appropriate for everyone. Factors to weigh when considering surgery include:

Level of Function

If you can heal from your ACL injury and resume nearly all your usual activities, surgery may not be necessary. However, if you are a serious athlete, surgery may be needed to maximize your function.

Additional Damage

If your orthopedist believes surgery will help prevent future damage to the knee cartilage, surgical ACL reconstruction might be the right choice for you.

Age and Overall Health

If the benefits of surgery do not outweigh potential health risks, conservative treatment might be a better choice for you.

ACL Reconstruction Overview

ACL reconstruction is typically performed on an outpatient basis using general anesthesia. Because the surgery is performed arthroscopically, incisions are usually quite small. One incision is made to insert a tiny camera called an arthroscope, while the other is used to place the necessary instruments into the surgical area to make the repair.

During your surgery, the surgeon will remove the torn ligament and replace it with the donor tissue. The graft is positioned and anchored to your joint using a fixation device like a screw. Most patients go home a few hours after surgery.

Recovery from ACL Reconstruction

You will use crutches after your surgery, so you don’t put weight on the knee. We will give you instructions on how to manage swelling and discomfort using ice and medication. Rehabilitation is usually needed to restore strength and function to the joint. Most patients are back to their regular activities within about six to nine months, although athletes may need up to one year to resume their pre-surgery performance level.

Frequently Asked Questions

Why is ACL reconstruction necessary?

Suppose you are an athlete who wants to continue competing and training, especially if your sport involves high-impact actions like jumping, cutting or pivoting. In that case, you will need to have ACL reconstruction performed in order to regain your normal ligament function. If not, you will likely not be able to perform at your previous level. 

Can ACL reconstruction be done twice?

Yes, ACL reconstruction can be performed numerous times, but typically, the difficulty of the procedure is increased each time the injury occurs. In some cases, you may even need to have ACL reconstruction revision, which fixes an unsuccessful ACL reconstruction procedure. 

Does ACL reconstruction last forever?

Forever is a long time, but generally, you can expect your ACL reconstruction to last for decades. This depends mainly on your unique injury and how your body chooses to heal and cope with the reconstruction surgery. We can provide you with some insight into how long you should expect your reconstruction to be effective during your consultation with our office. 

Can a reconstructed ACL tear again?

Yes, it is possible to sustain an additional injury after your ACL has been reconstructed. If you are in a high-impact sport or activity, speak with one of our professionals about how you can minimize the risk of sustaining additional injury. 

How long does the pain last after ACL reconstruction?

You should be done entirely with pain from the procedure by the two-week mark, but it will progressively and rapidly subside throughout that time. The first day after the surgery is the worst, but the pain and discomfort become significantly less intense as the one-week marker rolls around. Most patients can handle the pain with over-the-counter medications, but prescriptions are available when necessary. 

How many ACL reconstructions are done per year?

It is estimated that roughly 100,000 ACL reconstruction surgeries are performed each year on athletes and non-athletes who have torn one of their ACL ligaments. This means that your surgery is very routine, especially if you go with a surgeon from the Orthopaedic Institute of Ohio. They are highly trained and experienced when handling this type of injury.

How long after ACL reconstruction can I swim?

Unfortunately, you will have to avoid swimming and running for about five months after your ACL reconstruction. You can possibly do some swimming without engaging your legs, but even that will have to wait until about two or three months after surgery. If you accidentally use your legs during this time, though, there is a strong chance that you risk re-damaging your ACL and having to start the healing process all over. 

Is ACL reconstruction considered major surgery?

Yes, ACL reconstruction is considered a major surgery since it requires anesthesia, incisions and ligament manipulation. While every surgery has its risks, we will work with you to ensure your procedure is as safe as possible. You will likely be given a list of pre-operative instructions to follow in the weeks leading up to your procedure to achieve that goal. 

Is ACL reconstruction painful?

Pain only lasts about two weeks, but it progressively lessens as those two weeks pass. Whether you consider it painful depends on your own pain tolerance and what medications you use. Generally, most patients describe the pain as minimal. 

When can you drive after ACL reconstruction?

There are a few possible scenarios to answer that question fully:

Are you taking narcotic medication for pain?

If yes, you will need to avoid driving entirely. You are not allowed to drive while under the influence of narcotics, as it severely impairs your ability to operate machinery.

Was your surgery performed on your right knee?

If yes, you will need to wait about four to six weeks after your surgery, giving your ACL plenty of time to heal before making it do too much work on the car pedals.

Was your surgery performed on your left knee?

If yes, you should only need to wait about one week before driving or until you have recovered your standard reaction time. (This also assumes that you drive an automatic transmission. If you drive a manual transmission, you will need to wait four to six weeks.)

ACL injuries can be extremely painful and even life changing. In some cases, surgery is the only method to restore your function and your quality of life. To learn more about this procedure, contact Orthopaedic Institute of Ohio at 419-222-6622.