What is ACL Ligament Injury?
Knee joint is supported by four ligaments, which are needed for its stability. These ligaments are ACL & PCL, which are centrally placed, and MCL and LCL, which are peripherally placed. ACL is the most commonly injured ligament of the knee joint. This injury is commonly seen in young active individuals either during sports or road accidents. The patient frequently complains of instability, pain in the affected knee and is unable to pursue sports or sometimes-even activities of daily living.

What is Arthroscopy?
ACL injury is managed by arthroscopy where small keyhole incisions are made through which ACL ligament is reconstructed. This is very precise technique with minimal tissue trauma. Hence recovery is quite fast with very less pain. Once the ligament heals patient is allowed all activities without any restrictions.

How Normal Knee Works?
The knee is the largest joint in the body, and one of the most easily injured. It is made up of the lower end of the thigh bone (femur), the upper end of the shin bone (tibia), and the knee cap (patella), which slides in a groove on the end of the femur. Four bands of tissue, the anterior and posterior cruciate ligaments, and the medial and lateral collateral ligaments connect the femur and the tibia and provide joint stability. The surfaces where the femur, tibia and patella touch are covered with articular cartilage, a smooth substance that cushions the bones and enables them to glide freely. Semicircular rings of tough fibrous-cartilage tissue called the lateral and medial menisci act as shock absorbers and stabilizers.

What Is The Role Of ACL?
ACL along with other ligaments of the knee joint and meniscus provides stability to the knee joint. Its main function is to prevent anterior translation of knee joint.

What Is Ligament Reconstruction (ACL)?
Ligament reconstruction involves replacing the torn ligament with a tendon (graft) taken from your leg (hamstrings tendon) near the knee and fixing the graft in place with screws / suspensory fixation. This procedure is performed with the use of an arthroscope. The torn ligament is excised arthroscopically. Bony tunnels are prepared in femur and tibia using specialized instruments through which the new ligament is passed and fixed with special screws/ buttons under adequate tension and stability is confirmed on the table. Often a meniscal injury is associated which can be repaired or partial removal of the meniscus can be done depending upon its status. 

When Can The Patient Be Ambulated After Surgery?
The patient can walk from the same evening of the surgery. Initially the patient is advised to walk with a brace and a walking cane. Strengthening and range of motion exercises for the knee are started from the next day. The patient is discharged from the hospital next or day 2 after surgery. The patient can walk without support by 10-14 days depending on muscle strengthening. Slow Jogging and other strenuous activities are permitted after 3 months and the patient can return to active sports after 6 months of surgery.

Arthroscopic ACL Reconstruction