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ACL Surgery
Dr. Ambrose Yung
What is ACL Surgery?
ACL surgery is a procedure that repairs or reconstructs the anterior cruciate ligament (ACL), a key ligament that stabilises the knee during activities like running, jumping and pivoting.
A torn ACL can lead to knee instability, making everyday movements difficult. Surgery is often recommended for athletes or active individuals seeking to restore knee function. The procedure typically involves replacing the torn ligament with tissue from the patient’s body or a donor, restoring stability and preventing further knee damage.
Indications for ACL Surgery
ACL surgery is recommended for several reasons, especially when non-surgical treatments fail to restore knee function.
- Complete ACL Tear: A completely torn ACL can make the knee unstable, making it difficult to perform activities involving rapid movements or changes in direction. Surgery is typically required to restore stability and function.
- Recurrent Knee Instability: If the knee frequently gives out or feels unstable after a partial ACL tear, surgery may be necessary to prevent further knee damage.
- High Activity Level: Athletes or highly active individuals who participate in sports such as football, basketball, or skiing may need surgery to return to their prior activity levels and reduce the risk of future injury.
- Associated Knee Injuries: ACL tears often occur alongside other knee injuries, such as damage to the meniscus or cartilage. Surgical intervention may be required to repair these injuries and improve overall knee stability.
- Failed Non-Surgical Treatment: If physical therapy and other treatments do not sufficiently improve knee stability, surgery may be the next step to fully restore function.
Benefits of ACL Surgery
- Restores Knee Stability
ACL surgery stabilises the knee, preventing it from giving way during daily activities and reducing the risk of further injury. - Supports Return to Physical Activity
Athletes and active individuals can safely return to sports and physical activities with improved knee function. - Reduces Risk of Chronic Knee Problems
ACL surgery can help prevent long-term issues such as chronic pain and arthritis by stabilising the knee and reducing joint wear and tear. - Prevents Further Knee Damage
By addressing knee instability, surgery helps protect cartilage and ligaments, reducing the likelihood of further damage.
Preparing for ACL Surgery
- Medical Evaluation and Imaging: Before surgery, the doctor will perform a full medical assessment, including blood tests and a physical examination. Imaging tests such as an MRI are used to get a clear view of the ACL injury, ensuring your fitness and planning procedure.
- Fasting and Medication Adjustments: On the day of surgery, wear loose clothing and bring necessary identification and insurance documents. Follow fasting guidelines, which typically require no food or drink for 8 to 12 hours before surgery, to minimise anaesthesia-related risks as well as any necessary medication adjustments, especially blood thinners.
- Home Preparation for Recovery: Set up your home for limited mobility by keeping essential items accessible, and ensuring crutches or a knee brace are available as needed.
Step-by-Step Procedure
Here is what to expect during an ACL procedure, from arrival at the clinic to the completion of the surgery:
Arrival and Pre-Procedure Preparation
On arrival, you will change into a hospital gown, have your medical history reviewed, and receive an IV for fluids and anaesthesia.
Administration of Anesthesia
Anaesthesia will be administered through the IV line to induce sleep and keep you pain-free during the surgery.
Incision and Graft Harvesting
Small incisions are made around the knee to access the torn ACL. If the surgeon uses tissue from the patient’s body to replace the damaged ligament, it will be taken from the hamstring or another tendon.
ACL Reconstruction
The surgeon removes the torn ACL and replaces it with the new tissue, attaching it to the bone with screws or other devices.
Completion and Closure
The surgeon closes the incisions with stitches or staples. The surgery typically takes 1 to 2 hours.
Post-ACL Surgery Care
Proper care after an ACL surgery ensures a smooth recovery.
- Immediate Care: After surgery, patients are monitored as they wake from anaesthesia, with regular checks on heart rate and blood pressure. Pain medication is provided and most patients are discharged after 1 to 2 hours.
- Recovery Process: In the first few days, rest and leg elevation help reduce swelling. Crutches and a knee brace may be used for support. Physical therapy starts within a week, and full recovery may take several months.
- Dietary Recommendations: Start with light meals and gradually return to a normal diet to avoid any nausea or discomfort caused by the anaesthesia.
- Follow-Up: A follow-up appointment will be scheduled within a week or two to monitor healing, remove stitches or staples, and discuss further recovery steps.
Risks and Complications
While ACL surgery is generally safe, it carries some potential risks and complications that patients should be aware of. These include:
- Infection: There is a small risk of infection at the incision sites after surgery.
- Blood Clots: Blood clots in the leg can form if a patient is immobile for an extended period of time after surgery, but wearing compression stockings and moving early can help prevent them.
- Knee Stiffness: Some patients may experience stiffness or difficulty regaining full mobility following surgery. Physical therapy is recommended to help restore flexibility and strength.
Our Clinic Locations
Spire Hip & Knee Centre
6 Napier Road #08-04
Singapore 258499
Monday – Friday: 9.00am – 6.00 pm
Saturday: 9.00am – 1.00pm
Sunday & PH: CLOSED
Spire Orthopaedic Physiotherapy & Rehab Centre
101 Irrawaddy Road, #18-03
Singapore 329565
Monday – Friday: 9.00am – 6.00 pm
Saturday: 9.00am – 1.00pm
Sunday & PH: CLOSED
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Frequently Asked Questions (FAQ)
How soon can I return to sports after ACL surgery?
Most patients can return to sports within 6 to 12 months after ACL surgery, depending on their recovery progress and physical therapy. The timeline varies depending on the severity of the injury and the type of sport. Your doctor will assess your readiness during follow-up appointments.
What can I do to speed up recovery after ACL surgery?
Following your surgeon’s post-surgery instructions, attending physical therapy sessions, maintaining proper knee support, and avoiding high-impact activities during recovery can help accelerate healing. Proper nutrition and rest are also advised for a quicker recovery.
How will ACL surgery affect my long-term knee health?
If you follow your rehabilitation plan and avoid reinjury, ACL surgery can improve long-term knee stability and function. However, ACL injuries can increase the risk of osteoarthritis later in life, so maintaining knee strength and avoiding excessive stress on the joint is necessary for long-term health.