B) ACL augmentation – ACL has 2 bundles, anteromedial bundle and posterolateral bundle.
This procedure is done when only one bundle is torn and other is intact. Procedure is done
arthroscopically using one hamstring graft. We recommend FiberTape augmentation with
hamstring graft.
With ALL inside ACL reconstruction with FiberTape internal bracing knee bending is started first
day of the surgery. First postoperative day, you will be allowed to bend knee up to 90 degrees
and allowed to walk using walker with weight bearing as tolerated. Physiotherapy will start
immediately after the anesthetic has worn off. The patient will be able to go home the same
day. Ice packs can be used to treat swelling. Physiotherapy will be essential to help and
strengthen the musculature around the knee.
It depends on the nature of employment. For example, if the patient is having a sedentary style
of job, the patient will be able to go back to work within a week following surgery. However, if
the patient’s work involves walking and standing throughout the day, he will be able to return to
work by 4 – 6 weeks. This restriction is to avoid pressure on operated joint and also allows
patient to regain the confidence to walk independently.
People who lead an active lifestyle, professional and recreational sports persons whose activity
involve rotational and pivoting movements are good candidates for ACL surgery. This is
beneficial particularly for people who have been through a physiotherapy and rehabilitation
program but are still experiencing instability. This surgery can also benefit individuals who have
injured more than one knee ligament.
Everyone does not need ACL reconstruction. People willing to make lifestyle changes and avoid
the activities that cause recurrent instability can lead life without surgery. But people who wish
to return to sports definitely need ACL reconstruction. Important prerequisite for nonoperative
treatment is patient should not have recurrent instability.
Other options like ACL repair and ACL augmentation can be used as explained earlier.
All surgeries are associated with risk. ACL surgery is also associated with its own risks. But these
are very less as this surgery performed arthroscopically which does not need extensive incisions.
We use regional anesthesia which is relatively very safe. Risks may include bleeding, knee pain
or stiffness, reduced range of motion, wound healing problems and infection. But these are very
rare. So, ACL reconstruction is relatively very safe surgery and no need to be afraid of the
procedure.
ACL reconstruction is done arthroscopically using hamstring graft. We prefer ALL inside ACL
reconstruction with FiberTape internal bracing. Here we recommend implants made by reputed
international companies like Arthrex, stryker, conmed and smith and nephew. Arthrex, stryker,
conmed are USA based implants, smith and nephew is UK based. All these companies have best
quality implants. Femur side graft fixation is done with adjustable tight rope, graft internal
bracing done with FiberTape, tibial side fixation done with tight rope loop, ABS button and
swivel lock anchor.
It depends on multiple factors like younger age, preinjury hours of sports participation, and
amount of anterior instability. Younger the age more the chances of recurrent instability. Similarly,
sports activities need stability of joint. If the person is already having instability, they always need
surgery. If the surgery is not done on tine, femoral cartilage and meniscal damage will occur. After few
years osteoarthritis with persistent knee pain will develop
