Instability of the knee, swelling of the knee, feel or hear a ”pop” sound in the knee, pain in the knee with inability to continue activity.
If you are experiencing any of these symptoms then you might have an ACL (anterior cruciate ligament) injury.
In order to properly diagnose you, your doctor will take a detail history and do a thorough physical examination. Your doctor will also do investigations such as Blood test, X-rays, Ultrasound, CT scan, MRI, etc. to confirm the diagnosis or underlying cause for your symptoms.
Ligamentous knee injuries typically occur during sport which requires pivoting motion such as soccer, football, basketball, gymnastics, etc. or landing awkwardly from a jump or direct blow to the knee such as in a tackle in soccer or a motor vehicle collision. The most commonly affected ligament in the knee is the ACL and the most common ACL injury is a complete tear of the ligament. 50% of persons with an ACL injury also have damage to the cartilage lining the knee joint and the meniscus that acts as a shock absorber in the knee joint.
The ACL is responsible for preventing the forward movement of the leg relative to the thigh and also prevents inward rotation or twisting of the knee. Some persons with ACL injury will require removal of damaged ACL and replacement with a natural graft. This intervention can accelerate the healing process and reverse disability, in the case of athletes result in a shorter time to resume playing sports.
Your doctor may recommend surgery if;
- The injury is causing your knee to buckle or slip during everyday activities
- More than one ligament or the meniscus in your knee is also injured
- You're an athlete and want to continue in your sport, especially if the sport involves jumping, cutting or pivoting
If your doctor thinks ACL reconstruction surgery is right for you then the gold standard is a double bundle ACL reconstruction done via arthroscopy or key hole surgery to the knee. Key hole surgery has the benefit of less complications such as bleeding and infection, there is also shorter recovery time and return to work.
After surgery you'll resume another course of rehabilitative therapy. Successful ACL reconstruction paired with rigorous rehabilitation can usually restore stability and function to your knee. You will need to wear a knee brace.
The risk associated with surgery is low and therefore it is important to follow the instructions of your doctor before and after surgery. There are anesthetic complications such as reaction to medications used or urinary retention especially following spinal anesthesia. With respect to the surgery, there can be numbness or weakness in the legs due to long-term posture changes. Bleeding during and after surgery. Damage to nearby structure during surgery, such as nerves, blood vessels and kneecaps. Infection of bones or joints, which may occur immediately or shortly after surgery.
Do not eat or drink for around 6 - 8 hours before surgery. Do not take aspirin or other blood-thinning medications for at least one week before surgery. Patients should also inform their doctor if they are using any other medication. Patients will be given a physical examination, chest x-ray, EKG, and a blood test prior to surgery. Take medications as prescribed by your doctor. Avoid getting your surgical wound wet, as this can increase the risk of infection. Don’t miss your scheduled follow-up and treatment appointments.