About the surgery:
Arthroscopic ACL reconstructive surgery is keyhole surgery using a narrow pencil sized fibre-optic camera and light to look inside the knee joint. The ACL is reconstructed by replacing the torn ligament with a tendon graft. The tendon graft is taken from the hamstring tendons at the back of your leg, usually from the same leg but sometimes from the other leg. The ruptured ACL is removed and tunnels are drilled into your bone to accept the tendon graft. The graft is then passed through the tunnels and is fixed using a small steel button and screw.
What to expect after surgery:
You will normally remain in hospital for one night after the procedure. You will be given pain relief, intravenously (through a drip) and/or in tablet form. You will have 2 drains in your knee joint which will be removed prior to discharge.
Some swelling and pain in the knee is to be expected and is best treated by elevating your leg when seated for the first few days after surgery. An ice pack applied for 20 to 30 minutes every few hours will greatly assist to reduce the swelling and pain around your knee.
A physiotherapist will see you prior to discharge and advise on your physiotherapy plan. You should rest for the first few days after surgery and use two crutches for one to two weeks, then one crutch held in the hand opposite to your operated knee for another week or two. Gradually increase the weight through your knee.
On discharge you should not drive and will need to be collected by a friend or family member.
Caring for your wounds:
A surgical bandage covering the knee is used for compression to minimize swelling and can be removed two days following surgery. There will be small waterproof dressings placed over the incisions and these need to be kept clean, dry and remain intact for two weeks. You will have dissolving stitches in your wound which do not need to be removed. A small amount of bleeding into the dressing is normal, however if you have concerns about excessive bleeding, apply pressure to your knee, rest, apply ice and elevate your leg. Please do not hesitate to contact the rooms if you have any concerns.
Do not have a bath or swim until Mr Patten has seen you in his rooms at your post-operative appointment and he has cleared you for such activities. For further information regarding wound management, please read the ‘post-operative wound management’ leaflet provided to you by our rooms before surgery.
Managing your pain:
Pain is a normal part of the healing process after surgery and will slowly improve over time. In the early days following surgery you should rest and elevate the leg, as well as regularly ice your knee, as this will all significantly help to reduce pain and swelling.
On discharge from hospital you will be provided with some pain relief for pain control. For ongoing pain relief requirements, we suggest you arrange an appointment with your GP to obtain a prescription. After surgery you should take pain relief as long as you have pain, particularly when walking or at night. Patients generally cease their pain relief at around three to four weeks after surgery.
If you are concerned about your level of pain, please do not hesitate to contact our rooms for reassurance and to rule out a rare complication.
Recovery from surgery:
After surgery it is important that you protect your ACL graft, as it takes at least six months to mature and heal. Mr Patten will advise you specifically about returning to more rigorous activities.
The expected time off work is dependent on your occupation but is usually one to two weeks for office work. If your work is more labor-intensive or you need to frequently use stairs or climb ladders, you will require a longer period off work and Mr Patten will advise you directly.
If you have had surgery to your left knee you will generally be able to resume driving in one to two weeks, or three weeks if you drive a manual car. If you have had surgery to your right knee you could likely resume driving after three weeks.
Risks and complications:
Arthroscopic ACL reconstructive surgery is very safe and although uncommon, complications can sometimes occur. These can include a very low risk of infection which may require antibiotics, excessive swelling or bleeding inside the joint which generally requires rest and a firm bandage.