When to Consider ACL Repair
Initial signs of an ACL injury include immediate swelling, a loss of range of motion, and difficulty walking or returning to normal activities. Initial treatments include modification of activities, application of heat or ice, and over-the-counter or prescription pain medications. If these treatments aren’t effective, surgery may be recommended. ACL repair is also worth considering if:
- Pain is severe and disruptive
- Knee pain is impacting quality of life
- You are athletically active and want to return to competitive form
What is ACL Repair?
ACL repair refers to the process of reattaching the detached portion of the tissue to the tibia or femur. If the ligament has been pulled completely away from the bone, special screws may be used to reattach it. In some cases, the tear occurs at the mid-point on the ligament. If repair isn’t possible, reconstruction may be necessary. With reconstruction, a soft tissue substitute called a graft is used restore the ligament.
Is Arthroscopic ACL Repair Possible?
Arthroscopic procedures are often used to initially assess the damage that was done to the ACL to determine if repair or reconstruction will be necessary. During the procedure, tiny incisions are made so that a small camera can be inserted to allow the surgeon to view the affected part of the knee. The results of the initial evaluation will determine whether surgery will involve repair or reconstruction of the ligament. ACL repair is performed if there is separation of the ligament from the bone along with a piece of bone itself (avulsion fracture).
How is Arthroscopic ACL Repair Performed?
Arthroscopic ACL repair surgery is performed by making small incisions into the area of the knee where the damage ligament is located. Usually less than 2 inches in length, the incisions are used to insert special tools and a lighted camera. It’s an alternative to more invasive open surgery, which requires a larger single incision.
With some minimally invasive ACL repair procedures, sterile saline is placed through one of the incisions to expand the knee. This also allows the surgeon to wash the blood away to get a better view of the ligament. The ACL will be repaired with visual guidance from the camera that was placed in one of the other incisions.
During ACL repair surgery, the rest of the knee will be examined to determine if there are other issues that will need to be corrected to restore full function to the knee joint. If other problems are detected, ACL repair may be combined with the repair of damage to menisci, bones around the knee, or other supporting cartilage or ligaments. Arthroscopic ACL repair is usually an outpatient procedure, which means patients can go home on the same day.
What Happens After Arthroscopic ACL Repair?
Patients may be asked to remain where the surgery is performed for a short period of time for observation. Pain medications are often prescribed to manage any discomfort. Such medications are meant to be used on a short-term basis. Pain usually goes away as the knee continues to heal.
Physical therapy typically begins a few weeks after surgery or when the knee is strong enough to go through the various motions necessary to strengthen the repaired ligament and other supporting knee muscles. The extent of physical rehabilitation required will depend on how well a patient responds to individual sessions.
Since arthroscopic ACL repair is a minimally invasive procedure, patients often enjoy a faster recovery. Because of the techniques used, there’s less damage to nearby tissues and patients have fewer complication risks. The surgical success rate for ACL repair performed on candidates who are likely to benefit from the procedure exceeds 90 percent. Involving customized physical therapy and rehabilitation, full recovery often takes several months.