Knee reconstruction surgery, also known as ACL reconstruction, is a procedure used to restore stability to a knee that has sustained a torn ligament. The anterior cruciate ligament (ACL) is essential for proper knee function and, when torn, can substantially destabilize the knee, causing discomfort and impairing one's ability to participate in everyday activities. There are risks associated with knee reconstruction surgery, including issues with graft placement or acceptance and infection, and these should be considered prior to scheduling surgery.
The anterior cruciate ligament (ACL) is considered one of two major ligaments responsible for proper knee function and versatility. Covering the front of the knee joint, including portions of the femur and tibia, the ACL governs the knee's ability to bend, turn, and flex as needed for everyday activities, such as walking and running. In the event the ACL is injured or torn, the knee may “buckle,” compromising the tibia and the surrounding cartilage. The extent of the injury and its impact on knee function generally determines whether or not knee reconstruction surgery is warranted. If the ACL tear is substantial or its effects chronically compromise knee function, knee reconstruction surgery may be performed.
To restore proper function to the knee joint, the torn anterior cruciate ligament must be replaced. Generally performed arthroscopically, knee reconstruction surgery requires that several small incisions are made for the introduction of tiny instruments into the joint. The injured ligament is removed and replaced with a graft of synthetic or natural connective tissue. The substitute tissue is positioned the same as the original ACL and affixed, usually with screws, to the femur and tibia. If necessary, other repairs are made to the knee joint before the incisions are sutured back together.
Prior to knee reconstruction surgery, preoperative instructions are given to the patient. During consultation, the individual usually discusses whether he or she wishes the graft to be harvested from his or her own connective tissue, from a donor, or that a synthetic material be used instead. It is usually standard procedure for individuals to temporarily discontinue their use of any medications or supplements that may impede surgery success, such as the use of acetaminophen which may hinder blood clotting.
After knee reconstruction surgery, the individual is usually expected to participate in physical therapy to restore strength and flexibility to the mended knee joint. It is not uncommon for the individual to be fitted with a brace that may be worn during everyday activity for the first few weeks. Prescription-strength analgesic medication may also be given to manage knee discomfort in the immediate days following surgery. Most people who undergo knee reconstruction surgery are able to return to their normal activity level without restriction within several months.