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By Mayo Clinic staffIn most instances, general anesthesia is used during ACL reconstruction, so you'll be unconscious during the procedure. ACL reconstruction is usually done through small incisions — one to hold a thin, tube-like video camera (arthroscope) and the others to allow surgical instruments access to the joint space.
During the procedure
After removing the damaged ligament, your surgeon will replace it with a piece of tendon from another part of your leg or, possibly, from a deceased donor. Your surgeon will drill tunnels into your thighbone and shinbone to accurately position the graft, which is then secured to your bones with screws or other fixation devices.
After the procedure
Once you recover from the anesthesia, you'll be allowed to go home later that same day. Before you go home, you'll practice walking with crutches and your surgeon may ask you to wear a knee brace or splint to help protect the graft.
To reduce swelling and pain in the days immediately following your surgery, follow the R.I.C.E. model of self-care at home:
- Rest. Use crutches to avoid weight bearing on your knee.
- Ice. When you're awake, try to ice your knee at least every two hours for 20 minutes at a time.
- Compression. Wrap an elastic bandage or compression wrap around your knee.
- Elevation. Lie down with your knee propped up on pillows.
Progressive physical therapy after ACL surgery helps to strengthen the muscles around your knee and improve flexibility.
- Frontera WR, et al. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-6/0/1678/0.html. Accessed Oct. 25, 2012.
- Friedberg RP. Anterior cruciate ligament injury. http://www.uptodate.com/ index. Accessed Oct. 25, 2012.
- ACL injury: Does it require surgery? American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00297. Accessed Oct. 25, 2012.
- DeLee JC, et al. DeLee & Drez's Orthopaedic Sports Medicine: Principles and Practice. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-1-4160-3143-7..X0001-2--TOP&isbn=978-1-4160-3143-7&uniqId=230100505-57. Accessed Oct. 25, 2012.
- Barbara Woodward Lips Patient Education Center. Anterior cruciate ligament (ACL) reconstruction manual. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2002.
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