Anterior cruciate ligament (ACL) Reconstruction Surgery

The Knee Joint is a highly complex knee joint. The primary ligaments responsible for knee stability are:
- Anterior Cruciate Ligament (ACL)
- Posterior Cruciate Ligament (PCL)
- Medial Collateral Ligament (MCL)
- Lateral Collateral Ligament (LCL)
- Posterolateral Corner (PLC)
- Patellofemoral ligaments - MPFL and LPFL

The Anterior Cruciate Ligament (ACL)
This is the primary stabiliser of the knee preventing anterior translation of the thigh bone (femur) over the leg bone (tibia).
It is commonly injured in contact sports such as football, rugby, American football and basketball. It can also occur in non-sporting activities such as turning/twisting on the knee suddenly, landing on the knee in an abnormal position and vehicle accidents.

Tear of the ACL leads to:
- Give away sensation in the knee, with loss of stability
- Inability to walk fast or run
- Inability to go down stairs
- Difficulty in walking on uneven surfaces, such as sandy or rocky areas
- Apprehension while performing certain activities that the knee will buckle

Treatment of an ACL tear depends on:
- Activity levels of the patient
- Acceptance of a sedentary lifestyle

Frequently Asked Questions on Anterior Cruciate Ligament ACL tear
Q. For whom is ACL reconstruction surgery recommended?
A. ACL reconstruction surgery is recommended for:
- Those who want to maintain an active lifestyle (eg. participation in sports such as running, football, basketball, cricket, etc.)
- Those who experience instability in the knee in Activities of Daily Living (ADLs), eg. while walking, turning on the affected knee, walking downstairs, walking fast, walking on uneven surfaces, etc.

Q. What is done in an ACL reconstruction surgery?
A. The torn ACL is substituted with a graft. This is a knee arthroscopy (keyhole) surgery.

Q. Which grafts are used in ACL surgery?
A.  Grafts used are from the patient's own tissues, called "autograft". The following tissues are most commonly used:
- Hamstring graft of same side (Semitendinosus graft)
- Bone patella bone graft of the same side
- Quadriceps tendon graft of the same side

Very rarely, allograft may be used, however use is restricted based on the age of the sportsman.

Q. What are the advantages of an arthroscopy or keyhole surgery?
A. - Faster recovery
    - Smaller incisions
    - Less blood loss
    - Less damage to tissues

Q. What is the timeline of recovery after ACL surgery?
A. In an isolated ACL reconstruction surgery performed with ipsilateral hamstring autograft, we follow a standard protocol of muscle strengthening, weight bearing as tolerated with knee brace depending on comfort from the second day onwards, use of a walker for the first two weeks, gradual progression to a cane after 2-3 weeks, walking without support after 4-6 weeks, can start driving after 6 weeks, activities such as cycling and swimming after 6-12 weeks depending on progress, jogging and gradually progress to running after 12 weeks, non-contact sports such as badminton, batting after 6 months, and contact sports such as football after 9-12 months from surgery.


To make an appointment with Dr. Ravi Nayak or know more about arthroscopic surgery, Call +971551613857 or Email : advancedkneesurgery@gmail.com