The anterior cruciate ligament is a ligament that connects the tibia, or lower leg bone, to the femur, the upper leg bone. Anterior cruciate ligament surgery is required if the ligament is involved in an avulsion fracture. This happens when there is a separation of the leg and a piece of bone from the other parts of the bone. It is recommended that those who suffer from an avulsion fractures involving this ligament undergo anterior cruciate ligament surgery as soon as possible. The anterior cruciate ligament (ACL) can also experience a partial tear. In this case, surgery is postponed to see how the patient heals, and if he or she returns to normal with physical therapy.
ACL injuries can cause the knee to give out and for the person with the injury to feel as if their knee is unstable. Tears or injuries to this ligament typically occur during sports or with sudden movement. Whether repaired or not, an injury of the ACL can lead to chronic ACL deficiency and premature osteoarthritis.
Anterior cruciate ligament surgery repairs the ACL or even reconstructs it to restore knee stability. This surgery reattaches the ACL to the bone. Usually an autograft is used, which is a tendon from the person’s own body. Often the petallar tendon from the kneecap or one of the hamstring tendons is used. Sometimes allograft tissue is used which is from a donor. An orthopedic surgeon performs the anterior cruciate ligament surgery which can be either open surgery or arthroscopic surgery.
Anterior cruciate ligament surgery in the arthroscopic method requires small incisions to be made in the knee. Surgical instruments are then used through these incisions to repair the ACL. Many surgeons prefer this method, mainly because it can be performed at the time of diagnostic arthroscopy. This means that while the small incisions are made to diagnose the amount of damage, it is easiest to repair the ACL through anterior cruciate ligament surgery. Orthopedic surgeons also agree that the knee is an easy site on the body to see and to work on, so arthroscopic surgery is a good option for this type of injury. The surgery is usually done on an outpatient basis. Recovery takes several months to a year to resume normal activities, and some athletes are able to return to their sport activity in four to six months. Several months of physical therapy are required for strengthening the knee and leg.
Open surgery is another possibility, but it is not performed nearly as often as arthroscopic anterior cruciate ligament surgery. This type of surgery requires one or two days of hospital stay and a period of recovery as well.
Some people experience partial tears of the ACL that do not require surgery. However, if pain persists, anterior cruciate ligament surgery may be required. If arthroscopic diagnosis is made, and the orthopedic surgeon believes that surgery would help the patient, then arthroscopic anterior cruciate ligament surgery can be performed at the same time. Most people who have this surgery have reduced pain and better stability, although there are risks as there are with any surgery. Serious complications are extremely rare, but there can be infection at the surgical site, blood clots in the leg, damage to nerves or blood vessels, or numbness in the surgical incision area. Other problems can develop as well after anterior cruciate ligament surgery. There can be problems with the graft tendon loosening or with the screws that are used to hold the tendon in place. A few surgery patients experience a grating of the knee bone to the bottom of the thigh bone after surgery.
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