ACL Surgery Singapore

ACL reconstruction is a commonly performed surgical procedure that reconstructs the torn ACL so that the function of a normal ACL can be replicated. The end result is to have the torn ACL replaced by a “new” ACL.

ACL Reconstruction is a procedure with a minimally invasive approach. During surgery, an arthroscope (tube-like video camera) and other surgical tools are inserted via small incisions in the knee joint space. Your damaged ACL will then be removed and replaced with a segment of tendon from another part of your knee (graft). The graft acts as a base on which new ligament tissue can grow.

An ACL graft is a length of tendon used to replace the ruptured ACL ligament. Although ligaments and tendons serve different functions in the body, they are structurally similar as both consist of lengths of collagen, bundled together lengthwise.

Ligaments are not used for ACL reconstructions because ligaments in the human body are generally too short to be used. Those that may be long enough are too difficult to harvest and cannot be done without causing severe compromise to the patient.

Some tendons, on the other hand, can be readily harvested and used for ACL reconstructions without causing significant disability to the patient. Hamstring tendons are a good example of tendons that can be sacrificed, and are, in fact, the most common tendons harvested from a patient for ACL reconstructions.

Two (2) types of grafts are generally used for ACL reconstructions: autografts and allografts. Autografts are grafts harvested from the patient himself. As mentioned above, hamstring grafts are the most commonly utilized grafts in modern day ACL reconstruction.

However other grafts such as the middle third of the patellar tendon, part of the quadriceps tendon and even tendons from the lower leg have been used.

Allografts, on the other hand, are harvested from donors who have passed on. These allografts are then carefully screened for any transmissible diseases that the donor might have suffered from when alive.

If found suitable, then are then thoroughly cleaned and packed in sterile packages, ready to be used commercially.

Early recovery includes wound care and icing to reduce swelling. Braces and crutches are also used according to the surgeon’s discretion.

Successful long-term recovery is often dependent on the patient’s commitment to physical therapy and rehabilitation. These exercises begin soon after surgery. Goals for physical therapy and rehabilitation include increased mobility and strengthened muscles and tendons.

Recovery exercises are performed in a graduated fashion, getting patients to progressively weight bear, walk unaided, jog, jump, run and finally get back to their sport of choice.

Most people return to sporting activities somewhere between 9 to 12 months. This will depend on the appropriate and successful completion of your rehabilitation program.

Many factors also need to be considered before going back to playing sports as there are risks of reinjuring the reconstructed ACL. Every patient’s recovery process is different, but following your rehabilitation plan closely is important to regain strength and stability in the knee as well as improve your balance, agility and jumping skills.

It is important to follow and complete your recommended rehabilitation plan in order to achieve ideal results after surgery.

For most patients, the risk of any serious adverse event happening is less than 1-2%. However, as every patient is different, it is important that you have a detailed chat with your doctor with regard to your risk.

Some of the risks of ACL Reconstruction include:

• Infection at the surgery site
• Infection or viral transmission from allograft (cadaver) tendons
• Bleeding
  
• Numbness
• Blood clot
• Knee instability, stiffness, and kneecap pain.

There are several factors that may contribute to an individual’s susceptibility to ACL injury:

• Age is over 40
• Falling from heights
• Women are more prone to ACL injury due to their unique anatomical structure
• Missing a step in a staircase

It usually takes nine months to recover after the surgery. Athletes may need to wait eight to 12 months or longer to resume their sporting activities.

An MCL or medial collateral ligament tear can heal without surgery. Some partially ruptured ACLs, especially in children and teenagers, may also heal without surgery. However, complete ACL tears seldom heal due to the lack of blood flow.

An ACL sprain occurs when the anterior cruciate ligament is stretched or slightly torn but not completely severed. This type of injury is typically classified into grades based on severity, with Grade 1 representing mild damage and Grade 2 more significant but not complete tearing. An ACL tear, however, involves the complete rupture of the ligament, which significantly compromises knee stability. Both types of injuries can exhibit similar ACL tear symptoms and treatment protocols initially, but the severity of a complete tear often necessitates more intensive treatment, including possible surgery.

Surgery for an ACL injury is generally recommended if there is a complete tear of the ligament, especially in individuals who lead active lifestyles or engage in sports that require pivoting movements. Surgery may also be necessary if the knee continues to experience instability despite appropriate physiotherapy and rehabilitation. The decision for surgery takes into account the patient’s activity level, age, overall health, and personal goals. Ultimately, the aim is to restore stability to the knee to prevent further joint damage and return to pre-injury levels of activity.

The timing of surgery for an ACL tear can vary. Immediate surgery is not typically recommended as it may lead to increased scar tissue formation, which can complicate recovery. It’s generally advisable to wait until the swelling has subsided, and the patient has regained some range of motion through pre-surgery rehabilitation. This approach helps to ensure a better surgical outcome and a smoother post-operative recovery. The decision on timing should be made in consultation with an orthopaedic specialist, considering both ACL tear symptoms and treatment goals tailored to the individual’s circumstances.