This is individualized depending on the severity of the injury and the nature of activities and employment that you do. Your rehabilitation will be discussed in detail by Mr Schluter who will follow you at 2 weeks, 6 weeks and 3 months to provide an outline of what the physiotherapist will work on with you. For this reason physiotherapy rehabilitation is delayed until the graft is stable and safe to start without stretching or loosening the graft. The tendon graft is secured by specialized fixation but is not fully secured for 6 weeks until the bone in the drill tunnels grow into the graft and stabilize it. There is an additional incision used to harvest the graft on the front or inside of the knee (medial side). The tendon is placed through drill holes made in the footprint of the original ACL in the knee. The other portal is used for passing in small surgical instruments. A small telescopic camera (‘scope’) is inserted into one of the portals and this provides a view inside the knee joint. Reconstruction is performed using knee arthroscopy (“keyhole” or “knee scope” surgery) The procedure involves making two small incisions (less than 1cm long) on the front of the knee to create portal. Additionally, any meniscal tears present will be repaired if possible, or the torn pieces removed if not repairable. Surgical reconstruction is performed by replacing the ligament with a tendon graft harvested from the patella (kneecap) tendon or 2 minor hamstring tendons at the back of the thigh.
There may also be an associated meniscal (cartilage) tear of the medial (inner) or lateral (outer) meniscus or both. If these symptoms of instability are frequent despite rehabilitation with physiotherapy then surgery may be required to reconstruct the torn ligament. It is often injured when the knee twists abnormally through contact such as a rugby tackle or non- contact such as landing badly in netball and is normally associated with swelling and significant pain.įollowing a complete rupture of the ACL, the knee may feel unstable as the ligament generally does not heal, and have repeated episodes of giving way. It is particularly important in sports or activities to avoid the knee giving way when sidestepping or pivoting. The ACL is an important ligament in the knee that stabilizes the femur (thigh bone) on the tibia (shin bone).
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