The tough band of tissue that connects the thigh bone to the shin bone is called anterior cruciate ligament or ACL.
Since it runs through the knee diagonally, it is responsible for giving the knee joint stability. It also works by helping control the lower leg’s back-and-forth movement.
In most cases, knee injuries occur during sports like football, tennis, skiing, and squash.
ACL injuries account for as much as 40 percent of known sports injuries. When damage is extensive, a minimally invasive surgery might be recommended.
ACL tears often occur when the knee and the lower leg are twisted or when the lower leg extends too much.
Some of the most common causes of ACL injuries include:
- Collisions (i.e. football tackles)
- Incorrect landing (from a jump)
- Sudden direction changes
- Sudden stops
Once the ACL is torn, there is a possibility for the knee to become very unstable. It can also likely lose its full motion range.
When is surgery necessary?
For minor tears, conservative treatment will likely be prescribed. However, when multiple tears occur, immediate surgical intervention is often recommended to help stabilize the knees. This is done before too much inflammation happens which might result to permanent joint damage.
ACL tears cannot be repaired through stitching alone. A tissue graft (from the patient or a cadaver) that will serve as support for new ligament growth will be required.
Orthopedic surgeons can easily determine the severity of the injury and make immediate repairs through a minimally invasive surgery called arthroscopy.
Done under general anesthesia, the surgeon will make several tiny knee incisions. A fluid will then be injected in order to clean the joint. A fiber optic camera is inserted and will send detailed images to a television monitor. This will enable the orthopedic surgeon to see throughout the joint and identify the needed steps to repair the knee.
Years ago, knee surgeries are classified as open surgery and will often require at least a week-long hospital stay. Full recovery might also take several months.
Fortunately, with minimally invasive procedures, the patient can commence doing the daily routines more quickly.
Knee arthroscopy is also done to:
- Trim broken cartilage pieces
- Repair/remove the cartilage that cushions the space found between the knee bones (meniscus)
- Repair bone fractures in the knee
- Relieve buildup of fluid
- Repair the synovium (lining of the knee)
- Remove a fluid-filled sac that can develop at the back of the knee (Baker’s cyst)
Prior to the surgery, the doctor will likely suggest the following:
- Taking naproxen (Naprosyn, Aleve), ibuprofen (Motrin, Advil), Iopidogrel (Plavix), and other blood thinners should be stopped.
- Discussing other medical conditions or bleeding disorders you may have with your surgeon.
- Taking blood samples (in case a blood transfusion might be necessary).
- Letting the doctor know if you have flu, fever, cold, herpes breakout or other medical conditions that might require surgery rescheduling.
On the day of the surgery, you will likely be asked to do the following:
- If general anesthesia will be administered, you will be advised to stop eating or drinking after midnight.
- Be in the hospital on the scheduled time.
- Take any medications you are given with only a small sip of water.
After the surgery, expect the following:
- You will be asked to go home after a few hours.
- You will have a knee dressing (at least for the next few days).
- You will have to use crutches when needed.
- Since the surgery is minimally invasive, you can expect quicker recovery. However, the severity of the condition and the complexity of the repair may still affect the length of recovery time needed.