Arthroscopic ACL Reconstruction Surgery

 

​If you're dealing with an ACL injury and want to get back to your active lifestyle, it's important to explore all your treatment options. Our team is here to guide you through every step of the process, from diagnosis to recovery. Contact us today to schedule a consultation and learn how ACL reconstruction can help you return to the activities you love. 

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​What is a torn ACL?

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A tear of the anterior cruciate ligament (ACL) is one of the most common major ligament injuries of the knee. Many individuals describe the injury as feeling like the “knee popped out” or the “bone moved”. This sensation is often followed by a swollen and painful knee caused by bleeding from the torn ligament filling the joint with blood. While the swelling and pain typically diminish over time as the blood is reabsorbed, the knee often remains unstable. The anterior cruciate ligament is a very important knee ligament for stability of the knee. It is basically a “cable” or “rope” and a tear of this ligament usually causes significant instability of the knee. When torn, this instability can significantly affect knee function, particularly during activities that involve changing direction, lifting, climbing, or straining like sports or labor-intensive jobs. 

 

An unstable knee is also more prone to further complications, such as meniscus tears, loose bodies within the joint, or the gradual development of arthritis. If left untreated, the initial ligament injury can lead to significant deterioration of the knee over time.  

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Risk of Secondary Problems Without ACL Surgery

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While some individuals who tear their anterior cruciate ligament (ACL) and forgo surgery experience long-term success, a large portion of those who leave it untreated will develop significant secondary knee problems requiring various surgical procedures. Secondary problems include the development of torn cartilages, loose bodies, arthritis, or a painful knee. Women tend to experience worse outcomes with untreated ACL injuries compared to men. 

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Arthroscopic Anterior Cruciate Ligament Reconstruction Procedure

 

Arthroscopic ACL reconstruction surgery (arthroscopic anterior cruciate reconstruction) marked a major advancement in the treatment of an acute or chronic tear of the anterior cruciate ligament. Since 1987, advances in arthroscopic technology have made it possible to reconstruct the ACL without the need for a large incision, dramatically reducing recovery time and improving cosmetic outcomes.  

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Before reconstructing he ligament, a complete diagnostic arthroscopy of the knee is performed. During this step, the surgeon identifies and repairs any additional damage, such as torn cartilage, bone fragments, or other knee issues, ensuring the joint is in optimal condition for reconstruction. It is generally recommended to wait two to four weeks after the initial knee injury before undergoing arthroscopic ACL knee surgery and reconstruction. This waiting period helps reduce joint soreness and allows the knee to regain a full range of motion, which has been shown to improve surgical outcomes and ease rehabilitation. 

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Through the use of arthroscopy, a new anterior cruciate ligament can be made for the knee and be placed within the knee joint without making a large cut on the knee.  A one inch skin incision and three arthroscopy cuts are used to perform this operation. These small, cosmetically pleasing incisions allow for precise work with minimal scarring. Drill holes are carefully placed in the bone, and the new ligament is secured using dissolvable screws. 

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Patients and their surgeons can choose the material for the reconstructed ACL, customizing the procedure to individual needs. This approach offers effective restoration of knee stability while minimizing invasiveness and scarring.  

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Options for Replacing a Torn ACL

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The primary goal of ACL reconstruction is to replace the damaged ligament, which cannot heal on its own, with a new, durable ligament that can last a lifetime. Currently, human tissue remains the most reliable option for creating a replacement ligament with long-term durability. For initial ACL reconstructions, especially in high-level or professional athletes, most orthopedic surgeons in the United States recommend using the patient’s own tissue for the best outcomes. 

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For young, high-performance athletes or those engaged in physically demanding activities, the bone-patellar tendon-bone (BTB) graft is often the preferred choice. This method uses the middle third of the patellar tendon, along with attached bone on either end, to create a strong and durable ligament. This option is particularly suitable for aggressive, high-demand athletes due to its superior strength and stability. 

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For recreational athletes or individuals with lower physical demands, the hamstring tendon graft is a popular alternative. This technique uses the patient’s hamstring tendons to reconstruct the ligament. It is generally associated with less postoperative pain, fewer potential complications, and an easier recovery compared to the BTB graft. The choice of graft depends on the patient’s lifestyle, activity level, and personal goals, allowing the procedure to be customized to meet their unique needs. 

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Recovery & Rehabilitation After ACL Reconstruction

 

The arthroscopic technique for anterior cruciate ligament reconstruction allows this procedure to be performed as an outpatient procedure, meaning patients can return home the same day. 

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Recovery begins immediately following surgery. Patients can start walking with weight-bearing and crutches right away, gradually transitioning to one crutch and eventually walking without assistance as tolerated. The patient may start riding a stationary bicycle or use a StairMaster less than one week following the surgery to gently rebuild strength and mobility.  

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Some individuals go to physical therapy after surgery; while others choose to perform exercises on their own. While it is not mandatory to go to a physical therapist, it is mandatory to exercise the knee regularly for an extended period following the procedure. Consistent exercise is essential for a successful recovery. 

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Full recovery and rehabilitation of the knee typically take six to nine months. High-impact sports such as football, basketball, volleyball, and skiing are usually safe to resume around nine months post-surgery, allowing the new ligament time to establish a blood supply and strengthen. 

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ACL Arthroscopic Knee Surgery For Sports Injuries

 

If an individual is very active and wishes to continue playing vigorous sports and other high demand activities, then ACL reconstruction should be performed to restore knee stability. However, if someone feels their athletic career is nearing its end and they have become less active, surgery for a torn ACL may not be necessary. Dr. Chronister does not recommend continuing to play sports on an unstable knee as it has been shown repeatedly that the knee will go on to develop multiple problems as a result of the instability. 

 

 

 

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​Take the First Step Towards Recovery

 

If you're dealing with an ACL tear, don't let it hold you back. Dr. Chronister's team provides guidance and personalized treatment plans to help you on your path to recovery. Schedule a consultation today to discuss your options and take the first step towards healing.

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