ACL reconstruction takes a different recovery period depending on one’s physical health, type of surgery, and recovery process involved in rehabilitation. Here’s a general timeline:
Immediate Post-Surgery (0–2 Weeks)
Efforts made to decrease swelling and pain.
Crutches should be used and a special knee brace is to be put to use.
Begin gentle range-of-motion exercises.
Early Recovery (2–6 Weeks)
Begin exercising in order to facilitate the regaining of movements all over the body and muscular strengthening.
Gradually get off the crutches and begin to walk with them only in specific circumstances.
Improve quadriceps and hamstring strength.
Mid-Recovery (6–12 Weeks)
It highlights the necessity of strength training exercises as well as continued working on balance exercises.
Be practicing walking or jogging, but do not get into any rigorous exercise like football or basketball.
Increase flexibility and endurance.
Advanced Recovery (3–6 Months)
Engage in sport-specific training.
Concurrently carry out exercises for Jumping and agility.
Your physical therapist may discharge you for jogging.
Full Recovery (6–12 Months)
Majority of individuals can get back to high impact level of activity of high impact sports at between six months and nine months.
It is also important to note that it takes up to one year to achieve full ligament healing and strength recovery.
Factors Affecting ACL Reconstruction Cost​
ACL reconstruction surgery costs depend on many factors such as geographical location, the general facilities available in the hospital, the experience level of the surgeon, and other related medical costs. The following is a list of factors that define cost:
Type of Surgery & Graft Used
Hospital & Facility Charges
Surgeon’s Expertise & Fees
Anaesthesia & Medical Team Fees
Pre-Surgery Investigations & Tests
Post-Surgery Costs
Country & Location
ACL Surgery Success Rate​
The overall success rate of ACL reconstruction is usually high as majority of the patients are able to resume their normal activities and sports. Here’s an overview:
ACL Reconstruction Outcomes
85%–95% of patients regain their normal health and stability of the knee.
80%–90% return to sports at their previous level.
5%–10% patients may experience graft failure or need a revision surgery.
ACL Surgery Rehabilitation Exercises​
Rehabilitation is an essential part of the ACL reconstruction process, which aims at regaining strength and stability of the knee joint. Here is the phase-wise curriculum of ACL surgery physical therapy:
Phase 1: Early Recovery (0–2 Weeks)
Ankle Pumps
Quad Sets
Straight Leg Raises
Heel Slides
Seated Knee Extensions
Phase 2: Strength & Mobility (2–6 Weeks)
Mini Squats
Seated Leg Press
Hamstring Curls
Calf Raises
Stationary Bike
Phase 3: Advanced Strength & Balance (6–12 Weeks)
Lunges
Step-ups
Balance Board/Stability Exercises
Resistance Band Exercises
Elliptical or Swimming
Phase 4: Return to Sports (3–6+ Months)
Jump Squats
Lateral Side Steps with Resistance Band
Single-Leg Hops
Agility Drills
Sport-Specific Drills
ACL Surgery Complications​
Some common ACL surgery risks are:
Infection: The cases of infection after arthroscopic ACL reconstruction are very low. There have also been reports of deaths linked to bacterial infection from allograft tissue because of the improper procurement and sterilization techniques.
Bleeding and numbness: In very rare cases, there may be bleeding due to acute injury to the popliteal artery, and thus results in the weakening or the paralysis of the leg or foot. It is common to have numbness on the outer part of the upper leg next to the location where the incision is being made; this numbness may be temporary or permanent.
Blood clot: Although very rare, the blood clot in the veins of the calf or thigh can result in death. A blood clot may break off in the bloodstream and travel to the lungs, which results in pulmonary embolism or to the brain, and causes the stroke.
Instability: Recurrent instability may be due to rupture or stretching of the reconstructed ligament or due to poor surgical technique.
Stiffness: Knee stiffness or loss of motion may be experienced by patients after surgery.
Extensor mechanism failure: Rupture of the patellar tendon or patella fracture may be due to the weakening at the site of graft harvest.
Growth plate injury: In young children or adolescents with ACL tears, early ACL reconstruction can result in plate injury, which results in bone growth problems. The ACL surgery can be postponed until the child is closer to reaching skeletal maturity.
Kneecap pain: Postoperative anterior knee pain is very common after patellar tendon autograft ACL reconstruction.
ACL Tear Symptoms​
Most people consider ACL reconstruction when symptoms such as instability or pain are experienced from an ACL tear or damage. Common symptoms leading to this treatment include:
Knee Instability
Swelling
Pain
Limited Range of Motion
Difficulty with Daily Activities
Frequent Knee Buckling
Inability to Participate in Sports
Visible or Audible Pop During Injury
ACL Surgery Procedure Steps​
Specifically, ACL reconstruction is a procedure using minor incisions and arthroscopic view (camera inserted into the knee joint). It is normally a one to two hours procedure and the following procedures are performed:
Pre-Surgery Preparation
Patient Evaluation:
Check for abnormalities on knee ligament and cartilage through detailed internal assessment and MRI scan.
Discuss graft options:
Autograft is also learned as patient tissue taken from one part of the body, such as hamstring, patellar or quadriceps tendon.
Allograft (donor tissue).
Anaesthesia:
The general or spinal anaesthesia is carried out.
Arthroscopic Surgery Begins
Small Incisions:
Depending on the type of operation 2 – 3 ports: needle sharpened or scalpel is used to make incision on the knee.
Insertion of Arthroscope:
Instruments are then inserted to view the knee joint, especially a very small camera called arthroscope.
Removal of Torn ACL:
A corresponding incision is made and the damaged ACL is either trimmed or completely cruciate ligament is avulsed from its tibial and femoral bony attachment sites.
Graft Preparation & Placement
Graft Harvesting:
If the autograft is employed, this part is taken from the tendon.
This sculpture has been shaped into the appropriate size depending on the requirement to undergo the next procedure of grafting.
Bone Tunnel Drilling:
To harvest this graft two small holes are made in the tibia and the femur of the individual.
Graft Insertion:
This is inserted through the established tunnels of the bones and suturing the new ligament in place.
Graft Fixation
Securing the Graft:
Screws, buttons or bio-degradable implants are used to fix the graft.
The surgeon has an effective control on the tension as well as coordination of the incisions.
Stability Testing:
Knee is exercised to check the tightness of the graft as well as range of motion.
Closing & Recovery
Incision Closure:
Small puncture wounds are sutured using sutures or at times surgical tape is used to close it.
Knee is raised to be bandaged while the brace lies next to him.
Immediate Post-Surgery Care:
Crutches, knee brace are also offered.
Swelling and pain can therefore be eased through the use of ice and medicines that are meant to ease the level of pain.
The physical therapy is initiated within the first few days to avoid formation of a stiff joint.
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