Table of contents
- What is the anterior cruciate ligament (ACL)?
- What is an anterior cruciate ligament (ACL) injury?
- When will I need anterior cruciate ligament (ACL) surgery?
- What is anterior cruciate ligament (ACL) reconstruction?
- How long does anterior cruciate ligament (ACL) surgery take?
- What happens after anterior cruciate ligament (ACL) surgery?
- What are the risks and complications of anterior cruciate ligament (ACL) surgery?
- Pre-operative assessment
What is the anterior cruciate ligament (ACL)?
The ACL joins the thigh bone to the shin bone at the knee joint, and is a thick band of ligament tissue. It gives the knee stability by running diagonally through the inside of the knee: it also controls the lower leg’s back-and-forth movement.
What is an anterior cruciate ligament (ACL) injury?
Knee injuries account for 40% of all sports injuries, and activities such as skiing, football, tennis, rugby and squash can all lead to a torn ACL. A tear can happen if the lower leg extends too far forward or if the knee and lower leg are twisted. A torn ACL can leave the knee unstable with symptoms of giving way.
Common causes of an ACL tear include:
- Stopping suddenly
- Colliding with someone or something else
- Landing awkwardly from a jump
- A sudden change in direction
When will I need anterior cruciate ligament (ACL) surgery?
The decision to have surgery depends on the severity of the ACL injury and how much impact it is having on your quality of life. If you do not have an active lifestyle and your knee feels stable, you may not need surgery. However, delaying surgery could cause more damage to your knee.
Surgery can take place when swelling has reduced and the full range of movement returns to your knee, and when your thigh muscles are as strong as possible. A physiotherapist will help you with this and it can take at least six weeks after an injury for the full range of movement to return.
You will be advised to avoid any sports or activities which involve jumping, turning or twisting. The better your preparation before surgery, the better the results will be.
What is anterior cruciate ligament (ACL) reconstruction?
It is impossible to stitch a torn ACL together again, so the surgery is carried out by removing the remains of the torn ligament and replacing it with another leg tendon, such as the patellar tendon (which attaches the bottom of the kneecap to the top of the shin bone) or the hamstring. A graft tendon may also come from a donor, or a tubular synthetic substitute.
Depending on your circumstances and as a result of discussion with your surgeon, you will require either a general anaesthetic or spinal anaesthetic.
The procedure to reconstruct the ACL is carried out through key-hole surgery which allows your surgeon to operate inside your knee with minimal incision and scarring.
How long does anterior cruciate ligament (ACL) surgery take?
ACL reconstruction surgery lasts between one and one and a half hours. You may need to stay in hospital for one night but in some cases it can be carried out as a day case.
What happens after anterior cruciate ligament (ACL) surgery?
The knee is a complex joint, so it is important to look after it following surgery. Recovery usually takes around six months after your operation, but it may take up to a year for you to return to your sport.
What are the risks and complications of anterior cruciate ligament (ACL) surgery?
Function of the knee is restored in over 80% of cases following ACL surgery, but there are risks. Your knee may not be exactly as it was before your injury and you may still experience some restriction. Other, small, risks are those related to all types of surgery including infection, blood clots, nerve and blood vessel injury.
A pre-operative assessment is our opportunity to ensure that the procedure for which you have been referred is right for you. We’ll explain your treatment to you and makes sure that you are well enough to go ahead with it. It is also your opportunity to meet the team who will care for you and to ask any questions.
We carry out all the necessary tests and examinations in one outpatient session. While this may take several hours, everything is done in one go to save frequent visits before surgery.