Background
The anterior cruciate ligament is usually torn in an acute injury which can involve side stepping, jumping and twisting or from a direct blow in a tackle. There may be a pop or two and the knee will usually swell greatly within 24 hours. You may not be able to fully extend the knee. The knee will often take a few weeks to feel better only to then become unreliable once you return to sport. MRI scan will usually reveal the diagnosis and detect other possible injuries.
Indications
Reconstruction is necessary to restore stability and help reduce the risk of future early onset osteoarthritis. Dr Bartlett will discuss the possible options with you on the day of consultation.
Treatment/Pathology
ACL injuries will most commonly require ligament reconstruction however occasionally it may be possible to directly re-attach the ligament to bone. You will often have already seen a physiotherapist before seeing Dr Bartlett and it is usually beneficial to have preoperative rehabilitation to minimize the amount of muscle wasting that can occur before surgery.
Dr Bartlett will talk to you about your history and perform an examination. He can then look at your imaging (MRI) with you. In most circumstances we are able to access the images via electronic means however you should still bring the films along if you have them.
Surgical Detail
Reconstruction of the ACL is done via arthroscopic technique utilizing current well proven methods. The most common graft donor site is the hamstrings at the back of the thigh. The surgery is performed under a general anaesthetic and you will stay in hospital overnight. Dr Bartlett and the physio will see you on the day after surgery to discuss the surgery and get you mobile on crutches for the first 2 weeks.
Post-Operative/Recovery
You will see Dr Bartlett at 2 weeks when he will check your wounds and remove the brace. It's a good idea to make an appointment with your physiotherapist shortly after this (24-48 hours). You will see Dr Bartlett regularly over the next 7-9 months.
Key Points
Acute injury
Usually requires reconstruction
Excellent results for return to sport