• Locations: Bournemouth, Poole, Dorset
  • Private Secretary: 01202 316 249

ACL Reconstruction

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The anterior cruciate ligament is a large ligament in the knee. The anterior cruciate ligament lies in the centre of the knee and acts to stabilise the knee, particularly during rotation, pivoting, twisting and side stepping movements. Patients find that when attempting to return to activities, which involve twisting, turning of changing direction, the knee gives way or threatens to give way. This loss of stability maybe particularly evident during sports.

Injury to the knee is diagnosed by a combination of clinical history and examination by a doctor and imaging of the knee with an MRI or magnetic resonance imaging scan.

Once the ligament has torn, the ligament has no capacity to fully heal. This may result in loss of functional stability of the knee.

Surgical reconstruction may be avoided in patients where the knee remains stable during activities of every day living and who have lower demands in relation to pivoting, sports and activities.

Reconstruction of the ligament is often recommended for patient who have instability during activities of daily living or wish to return to sports, particularly those which involve directional change.

The aim of surgical reconstruction is to restore rotational stability to the knee, allowing the patient to return to activities and sports.

In addition, restoration of stability of the knee may avoid episodes of the knee giving way, resulting in damage to other important structures within the knee joint.

The Operation

A new anterior cruciate ligament is made by replacing the ligament with graft. This usually involves using either the hamstring tendons or the patellar tendon from the front of the knee.

The hamstring tendon is the most widely used graft and has a number of advantages over the bone patellar bone graft.

The surgery is performed predominantly as a keyhole or arthroscopic operation and the hamstring graft is threaded through the knee to recreate a new tendon.

The procedure is performed under general anaesthesia and this is augmented with a femoral nerve block, in which local anaesthetic is used to block one of the main nerves to the leg. This provides pain relief for a period following the operation.

The procedure can be performed as a day case or as an overnight stay. Post-operatively the knee is protected on crutches for a period of 2-3 weeks. Physiotherapy starts immediately.

Operation complications can occur and these include the development of venous thrombosis, wound infection and re-rupture of the graft. Anterior knee pain or discomfort relating to the kneecap or patella can occur even with hamstring grafts.

In addition associated injuries to the knee, particularly injuries to the joint surfaces of the knee can affect return to full function.

Graft loosening can occur over a period of time and cause early failure of the graft.

In the immediate post-operative period, bruising can occur with some swelling, but this will normally resolve within 2 weeks.

How to find us

Nuffield Health Bournemouth Hospital 67 Lansdowne Road Bournemouth BH1 1RW

Harbour Hospital, St Mary's Road, Poole, Dorset. BH15 2BH