ACL injury is diagnosed clinically from taking patient history which is usually a pivoting injury of the knee whilst playing football or changing direction suddenly. It’s usually associated with severe immediate pain with the inability to weight-bearing fully as well as significant swelling. The Diagnosis is usually confirmed by an MRI scan of the knee.
There are different thoughts in this matter. It was noted that early reconstruction can cause arthrofibrosis and knee stiffness, but this has not been rigidly confirmed. Most surgeons prefer delaying the operation for approximately two weeks post injury unless there is an associated meniscus injury in which case surgery early is recommended.
This entirely depends on your type of policy. Most policies cover the procedure, unless it is a professional sport injury in which case policy has to indicate coverage of professional sport injuries.
Most patient tends to suffer from instability in the knee due to the lack of ACL support. Also, the dynamics of the knee joint without ACL support will be different and this can lead to progressive osteoarthritic changes on the long term.
ACL reconstruction surgery takes approximately 1 ½ hour. We perform diagnostic arthroscopy to confirm the tear of the ACL and to examine the rest of the knee before we harvest the graft from the hamstring muscle and then we perform the placement of the graft within the knee appropriately after drilling the tunnels within the femur and tibia to take the graft adequately.
Post-operative pain is mild to moderate and it is approximately 4-5/10 and can be controlled well with simple oral analgesia. There is no need for hospital stay for pain control in almost all cases.
Most patients return to work within 1-2 weeks. I do not give my patients crutches after ACL reconstruction but I feel it is reasonable to rest for 1-2 weeks, allowing the soft tissue swelling to settle down. This is again depending on the type of your job and definitely no more than 1-2 weeks are needed if you are doing an office-based jobs.
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