Of the four ligaments that stabilize the knee joint, the anterior cruciate ligament (ACL) is one of the most commonly injured. The ACL supports front-to-back and rotational joint function. It is very strong but not very elastic, so sudden twisting or stopping movements can cause it to stretch or tear possibly requiring ACL reconstruction surgery.
Spring sports in Colorado – from spring skiing conditions to slick, wet, or snowy surfaces – provide the unpredictable terrain that can lead to that unwanted sudden twisting or stopping. Heavy wet spring snow can unexpectedly grab and hold a ski and the resulting torque between the alignment of your feet and knees can cause an ACL tear. As can snowy, or wet and slick conditions that challenge athletes competing on grass, turf, or the track. When youth athletes sustain knee damage that includes multiple ligaments or the meniscus, ACL reconstruction surgery may be the best path to recovery.
ACL reconstruction requires advanced preparation and planning as well as careful post-operative care. Each patient’s ACL replacement surgery plan is unique and factors that shape that plan include age, fitness level, the severity of the damage, joint flexibility, swelling, and lifestyle activities.
Generally, ACL reconstructive surgery is performed between three- and six weeks following injury, allowing time for pre-surgery physical therapy, which is used to reduce swelling, maximize joint function and improve muscle strength to aid recovery.
In addition to preparing for surgery, it’s also important to prepare a support plan that allows for activity limits during recovery. Weight-bearing activities, driving and physical activities will be limited in the first weeks following surgery, so it is important to have an advanced plan to support the healing process.
ACL reconstruction involves removing the damaged ligament and replacing it with a graft tendon. The graft may be taken from the hamstring, quadriceps, or knee, or a donor tendon may be used.
The procedure is an outpatient procedure performed with general anesthesia. A specialized orthopedic surgeon will make two small incisions in the knee. The first incision allows a micro camera to guide the surgeon and the second is used as an access point for the surgical tools needed to perform the procedure. During surgery, the torn ligament is removed, and holes are drilled to anchor the new graft to the bones in order to restore joint stability.
Recovery will include an individual plan that may include pain relief, activity limits, and physical therapy. Although a walking aid is used to limit the weight-bearing burden on the joint for the first 7-10 days following the procedure, joint exercises will begin immediately and gradually progress as the joint function improves and pain tolerance allows.
Rehabilitation plans aid recovery from surgery and help patients adopt efficient body movements that reduce the strain on the ACL.
Many patients find substantial joint function restoration as early as two weeks after surgery. As the need for a walking aid subsides, activities such as driving may resume. A progressive physical therapy plan will strengthen the surrounding muscles to support joint stability and continued recovery. The return to full activity is typically achieved in six to nine months as a full range of motion is realized without joint or soft tissue pain.
Orthopedic specialists guide patients on recovery timelines and give clearance when it’s time to resume competitive sports or other activities that rely on knee strength and mobility. They will also provide recommendations on the use of a brace or any activity limits as each patient returns to their routine. By closely following the post-procedure rehabilitation plan and maintaining consistent communication with the orthopedic team, most patients can safely resume previous activities after a full recovery.
Learn more about CCOE’s sports medicine and knee specialists and treatment of ACL tears. Want to make an appointment? Contact us at any of our three convenient Colorado Springs locations.