ACL Reconstruction is a surgery to reconstruct the anterior cruciate ligament, located in the knee. This ligament joins the tibia bone with the femur. The rupture of this ligament usually occurs during sports where frequent lateral or crossed movements are made, such as soccer, football, basketball, or gymnastics.
In the procedure, the damaged ligament is removed and replaced with a tendon section from the patient's knee or a donor. The Orthopedist makes small cuts around the knee joint.
Before the procedure, the Orthopedist will generally recommend physical therapy weeks after the injury, to ensure that there is as much movement as possible in the knee before the surgery, reduce inflammation, and strengthen the muscles.
If taking any medications or nutritional supplements, it is important to report them to your doctor, especially aspirin or some anticoagulant medication. The doctor may ask you to stop taking them at least a week before surgery to reduce the risk of bleeding.
As for anesthesia, mostly general anesthesia is used, and the patient will be in deep sleep, and will not feel pain. In other cases, another type of local anesthetic or block may be used. Follow all the instructions of your Orthopedist.
Generally, the surgery lasts between two hours and a half to 60 minutes, using general anesthesia, in most cases. The Doctor will remove the damaged ligament, and it will be replaced with a graft made from a section of a tendon from another part of the patient's knee (autograft), or a deceased donor.
During the procedure, a small camera is inserted into the knee through a surgical cut. The camera connects to a video monitor where the surgeon can see ligaments and other tissues. After this, the surgeon will make other incisions around the knee, including the femur and tibia, and will place the graft, connecting it to the bones with screws or other devices to fix it properly. The new tissue will be able to grow around the new ligament graft.
Ligament reconstruction surgery is outpatient, so once the patient recovers from anesthesia, they can be discharged that same day. Nevertheless, you must walk with crutches first, and the doctor may suggest using a splint or knee brace to protect the new graft. To control pain and swelling, the doctor will give specific care instructions, including keeping the leg elevated, applying cold packs or ice to the knee, and rest. Medications to control pain can be over-the-counter such as acetaminophen, ibuprofen, or naproxen sodium.
In case the pain is severer, the doctor may prescribe meloxicam or gabapentin. It is vitally important to follow the Orthopedist instructions on when and how to apply ice to the knee, how and when to change bandages, the time required to use crutches, and when it is wise to start the physical activity with the knee. After surgery, doing physical therapy for a considerable time will go a long way to strengthening the knee muscles and improving flexibility.
BlueNetHospitals - Hospital Los Cabos
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