ACL Tear Surgery: What to Expect, Recovery Time, and Outcomes

ACL Tear Surgery

An ACL tear is one of the most common injuries, particularly in sports that require abrupt stops, jumping, or changing directions. Often, reconstruction surgery on the ACL is necessary to regain stability and knee function. Knowing what to expect from the surgery, recovery time, and outcomes can help prepare the patient for this major surgery.

What is ACL Tear Surgery?

The reconstruction of the torn ligament is done by means of a graft. This graft may either be autograft from the patient’s own body or allograft from a donor. The procedure tends to be arthroscopic, involving minimal incisions and utilization of a camera. This minimally invasive approach tends to be less painful and yields quicker recovery times than the traditional open methods.

Indications for Surgery

Surgery is most commonly advised for people whose knee instability is severely bothering them or to play at a high level of competition. With conservative measures like PT/bracing, if the patient doesn’t get relief of symptoms, then patients should consider the option of ACL reconstruction.

What Happens During ACL Tear Surgery

Pre-Surgery Preparation

Prior to surgery, patients will have a full assessment with their orthopedic surgeon. This may involve imaging studies, such as an MRI, to assess the degree of the injury. Patients could discuss their medical history, including any prescription medications they may be on with the surgeon.

On the day of surgery, patients will receive anesthesia, which can either be general or regional, and will be monitored closely for the duration of the operation. The duration of the procedure varies from one hour up to two hours.

Post-Operative Care

Post-operatively, patients will be transferred to a knee brace and given crutches. Pain management is a key element of post-operative care, with medications prescribed at appropriate times. The first days post-operatively are critical in terms of managing swelling and starting gentle movements.

Recovery Timelines

The recovery time of ACL tear surgery is significantly different among individuals and takes considerable time. In general, the entire process can be divided into several stages:

In Stage 1, from Weeks 1-2, the main objectives are to decrease swelling and establish a range of motion. Patients are asked concentrate on resting, icing, and utilization of the RICE method as they perform gentle exercises with the aid of a physical therapist while walking on crutches.

 Stage 2 includes Weeks 3-6 and focuses on strengthening and more purposeful mobility with increased physical therapy of balance, and strengthening – quadriceps and hamstrings, as all patients walk without crutches by the end of this stage. 

Phase III: During Months 2 and 3 Patients should continue to progress strength and functional movement, depending on the swelling, can include some light jogging and more active strengthening activity, except for extreme high-impact activities. 

Finally, during Phase 4, Month 4 to Month 9, the aim is to progress back to sports-specific training where patients gradually increase their level of activity while participating in sport-specific drills, and most competitive athletes require nine months or more to return to pre-injury levels of performance.

Expected Outcomes

The success of ACL ligament tear treatment surgery is multifactorial including the patient’s age, level of activity before injury, adherence to rehabilitation protocols, and general health. Here are some expected outcomes:

1. Restored Stability: The majority of patients see a considerable improvement in knee stability post-surgery.

2. Decreased Pain: With proper rehabilitation, their pain levels are anticipated to be reduced significantly after a few months.

3. Return to Activity: Many athletes can return to their pre-injury level of competition within 9-12 months post-surgery.

4. Risk of Re-injury: While many individuals successfully return to sports, there remains a risk of re-injury or complications if proper precautions are not taken during recovery.

ACL ligament tear surgery is a crucial intervention for those who have significant knee instability due to an ACL ligament tear. Knowing what to expect before, during, and after the procedure will effectively help patients navigate their recovery journey. Most can look forward to regaining full function in the knee and return to favourite activities a few months after surgery with dedicated rehabilitation efforts and adherence to medical advice.

When discussing surgery or even at the recovery stage from an ACL tear, it is very important to have constant communication with the surgeon and physiotherapist for optimal treatment. 

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