Anterior Cruciate Ligament (ACL) Surgery
Anterior Cruciate Ligament (ACL) Surgery Lincoln county Hospital Lincoln
Also offered at: BMI Hospital Lincoln Lincolnshire.
Professor surgeon Mohammad Maqsood consultant Trauma & Orthopaedic Surgery Lincoln
Surgery for anterior cruciate ligament (ACL) injuries involves mostly reconstructing or repairing( rarely in children ) the ACL.
ACL reconstruction surgery uses a graft to replace the ligament. The most common grafts are auto grafts using part of your own body, such as the tendon of the kneecap (patellar tendon) or one of the hamstring tendons. Another choice is allograft tissue, which is taken from a deceased donor.
Repair surgery generally is only used in the case of an avulsion fracture (a separation of the ligament and a piece of the bone from the rest of the bone). In this case, the bone fragment connected to the ACL is reattached to the bone. It happens most of the time in children.
ACL surgery is done by making small multiple incisions around the knee or for arthroscopic (key hole) assessment and reconstruction. But it can be done with mini Open surgery which is used to take graft and reconstruction after Key hole assessment.
It can be done at the same time or as a separate procedure. Which can help to confoirm the lesion and also assess and dal with other injuries like Meniscal (Cushion cartilage) injuries or articular cartilage(covering cartilage) injuries. It can also be used for clearance and debridement of the debris, which help to reduce the scarring or arthrofibrosis.
Graft for ACL reconstruction
There are many types of tissue graft which can be used for the ACL reconstruction, but two grafts are commonly used at Lincoln county Hospital and Lincoln BMI hospital by Professor Orthopaedic surgeon Mohammad Maqsood. He uses mainly the Bone patellar Tendon Bone graft and sometimes Hamstring graft. There is evidence that BPTB graft from patellar tendon is stronger and best suited for athletes and very active sport personalities.
After ACL reconstruction surgery, the rehabilitation programme is all written for the guidance of patients and the physiotherapists. This is step by step approach, starting on the day of surgery and progressively reached to full return back to normal sport activities. Simply the patient can return back to play football or similar sport after 9 months.
Professor Mohammad Maqsood does not use any brace or splint after the ACL reconstruction. Patient have simple dressings and start mobilising fully weight bearing on the day of surgery. They can be discharge on the day of surgery or maximum overnight stay. They are allowed to move the knee joint freely, with no restriction.
Why ACL need reconstruction?
The goal of ACL surgery is to restore normal or almost normal stability in the knee and the level of function you had before. The knee injury with ACL rupture is very disabling, Patient cannot trust on the knee joint. Knee joint gives way and each episode causes damage to the Meniscus (cushion cartilage ) or Articuar cartilage(Covering cartilage), which mean early set –up of arthritis.
It is very rare that you may be suitable candidate to not have surgery. Professor Maqsood have seen now and collected data of patients who did not have surgery and ended up with recurrent episodes of Giving way and early damage to Meniscus or articular cartilage and early arthritis. Now a days we know that there is very little role of conservative treatment of the ACL rupture. But still some people can choose conservative option if:
- Have a minor tear in your ACL (a tear that can heal with rest and rehab).
- Are not very active in sports and your work does not require a stable knee.
- Are willing to stop doing activities that require a stable knee or stop doing them at the same level of intensity. You may choose to substitute other activities that don’t require a stable knee, such as cycling or swimming.
- Can complete a rehab program that stabilizes your knee and strengthens your leg muscles to reduce the chances that you will injure your knee again and are willing to live with a small amount of knee instability.
- Do not feel motivated to complete the long and rigorous rehab program necessary after surgery.
- You have medical problems that make surgery too risky.
Professor Mohammad Maqsood Consultant trauma & orthopaedic surgeon at Lincoln County Hospital Lincoln and BMI hospital Lincoln has many years of experience performing ACL reconstruction, Articular cartilage repair, and Meniscal repair.
For further information or appointment contact:
Secretary Leas Bristow: tel: 01522 787332
Or BMI Hospital Lincoln: 01522 578000