ACL Reconstruction & Repair
The anterior cruciate ligament, or ACL, is a ligament that runs diagonally in the middle of the knee joint. The ACL provides rotational stability to the knee and prevents the tibia (shinbone) from sliding out in front of the femur (thighbone).
ACL tears are among the most common knee injuries, particularly among athletes in high-demand sports like basketball, football, and soccer. If the ACL is sprained, the injury may heal with nonsurgical treatments. However, if the ACL is torn, surgery is usually necessary to restore stability in the knee.
Dr. Andrew Islam is highly skilled in both ACL repair and reconstruction procedures for ACL tears, performing an average of 5 procedures per month. Dr. Islam is also one of the few orthopaedic surgeons offering ACL repairs as an alternative to ACL reconstruction, which may allow for less pain and quicker recovery after surgery.
Causes & Symptoms of ACL Tears
ACL tears often occur during sports activities, but are common among non-athletes, as well. ACL tears can occur when a person rapidly changes directions or stops suddenly while running, lands a jump incorrectly, or collides with another person or object.
Immediate symptoms of an ACL tear may include pain and a “popping” sensation. The knee typically swells within 24 hours and may become unstable. You may also feel pain or tenderness along the joint line, and it may be difficult to walk.
If you suspect you have an ACL injury, seek help from a medical professional.
Surgical Treatment Options for ACL Tears
Nonsurgical treatment options may be helpful if the ACL is simply sprained or if the patient has a low level of activity, but a torn ACL will not heal without surgery. Dr. Islam typically recommends surgery for ACL tears to provide greater stability in the knee and reduce long-term risks of arthritis.
Traditionally, a torn ACL is surgically reconstructed using a tissue graft. However, Dr. Islam also offers ACL repair, and is one of the few orthopaedic surgeons to offer this procedure. In the right cases, ACL repair can provide a great result with less pain and shorter recovery times than ACL reconstruction. Dr. Islam tailors his recommendations and approach to each patient to provide the best possible results in each case.
ACL Reconstruction
In some cases, the torn ACL cannot be stitched back together, requiring a reconstruction procedure. During an ACL reconstruction, Dr. Islam uses a tissue graft to rebuild the ACL and provide a strong foundation for tissue regrowth. Grafts may be taken from the your patellar tendon or quadriceps tendon, or a cadaver graft may be used. Dr. Islam will review graft options with you prior to surgery to choose the option that best meets you needs.
ACL reconstruction is typically done as an outpatient procedure. Patients are sedated during this procedure and typically receive a nerve block in the area being operated on, which helps manage pain the first day or two after surgery. The procedure typically lasts about an hour. You will need to spend some time in recovery after the procedure while the sedation wears off.
ACL Repair
During an ACL repair procedure, the torn ligament is stitched back together, rather than reconstructed with a tissue graft. Because a tissue graft is not used, patients may experience less pain after surgery and quicker recovery times.
Like ACL reconstruction, ACL repairs are typically outpatient procedures done under sedation with a nerve block administered to the surgery site. The procedure lasts about an hour, plus time in recovery afterward. You will be able to go home the day of the procedure.
Recovering from ACL Surgery
After surgery, it is normal to experience some pain and swelling, which is managed with icing and elevating the knee above heart level. Some degree of swelling may be present for several months, but usually decreases significantly within a few weeks of surgery. Dr. Islam will prescribe pain medications to help with the initial pain, but most patients switch to over-the-counter pain medications within a week of surgery. You may also experience a small amount of numbness around the incision site, which may subside over time.
Surgical dressings can typically be removed 3 days after surgery. Once the dressings are removed, you may get the incision wet in the shower, but do not scrub the incision area. You may, however, gently rinse the area with soap and water. You should avoid submerging the knee in water for at least 4 weeks after surgery.
Patients are allowed to put weight on the knee once they are comfortable. This can vary, depending on the type of procedure and whether there were any concurrent procedures. Crutches are typically recommended for getting around until the patient is able to walk without a limp. Knee braces are typically not needed after surgery unless additional procedures, like a meniscus repair, were performed concurrently. In these cases, a brace will be worn for 6-8 weeks after surgery. Athletes are typically custom-fitted with a “return to play” brace to wear while participating in sports for 12-18 months. Patients usually begin physical therapy a few days after surgery, with a program that gradually advances over several weeks or months to help regain strength and motion in the knee. Dr. Islam often recommends biologic therapies to aid in recovery.
Athletes are typically cleared to return to sports within 9-12 months for ACL reconstruction and 6 months for ACL repair. Patients with desk jobs may be able to return to work within a week of surgery. Patients whose jobs require a lot a standing and walking may need to take as much as 4-6 weeks off from work. Patients are not permitted to drive until they are off narcotic pain medications. After that point, if you left knee was operated on, you may begin driving as soon as you feel comfortable. If the procedure was done on the right knee, Dr. Islam recommends waiting 4-6 weeks before driving again.
ACL Reconstruction & Repair Surgery in Cincinnati, OH and Surrounding Communities
Dr. Andrew Islam is highly experience in ACL reconstruction and is one of the few orthopaedic surgeons currently offering ACL repair. Dr. Islam completed a fellowship at the world-renowned Cleveland Clinic Foundation, during which he gained extensive experience in the care of athletes and athletic injuries. If you would like to schedule an appointment with Dr. Islam, please call one of Dr. Islam’s four office locations or fill out our Appointment Request form.
Additional Source Material
Anterior Cruciate Ligament (ACL) Injuries
ACL Injury: Does It Require Surgery?