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Anterior Cruciate Ligament Tear Repair


Why is this procedure done?


The anterior cruciate ligament is a strong band of tissue in your knee. It is also called the ACL. The ACL keeps the lower leg bone from sliding out in front of the upper leg bone. This controls the back and forth motion in your knee. The ACL acts like a rope to keep the knee stable. The ACL is one of the most commonly injured ligaments in the knee. Your ACL may be stretched or torn. This will cause you to have knee pain and swelling. You may also be unsteady when you walk on or move your knee. ‚  
A brace and physical therapy may help some people who are not very active. The only way to fully fix a torn ACL is with surgery. Doctors rarely sew torn ACLs back together since this most often fails. Instead, doctors replace the ligament with a tendon from another part of the body or from a donor. This is called an ACL reconstruction. ‚  


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What will the results be?


The doctor will repair or replace your damaged ACL. Your signs will improve. Your knee will be stronger and your walk will be steadier. ‚  

What happens before the procedure?


  • Your doctor will take your history. Talk to your doctor about:
    • All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
    • Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ฎ, ibuprofen, Aleve ‚ ฎ (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
    • If you need to stop eating or drinking before your procedure.
  • Your doctor will do an exam and may order:
    • Lab tests
    • MRI scan
  • You may not have surgery right away. The doctor may wait for your swelling to go down.
  • Your doctor may have you wear a brace on your knee before the surgery. This will keep your knee stable. You may also go to physical therapy before your surgery.
  • You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.

What happens during the procedure?


  • Once you are in the operating room, you will be given a drug to make you sleepy. It will also help you stay pain free during the surgery. The staff will put an I.V. in your arm to give you fluids and drugs. The doctor may give you a drug to make your leg numb. This will last for a few hours.
  • When you fall asleep, your doctor will clean your knee using an antiseptic and place a band around your leg above the knee. The band will lessen bleeding in your knee during the surgery.
  • Your ACL may be repaired with one of two different surgeries. You may need to have stitches, a screw, or a graft depending on how bad the ACL is hurt.
    • Open surgery ข ˆ ’The doctor will make one bigger cut on your knee. The doctor will fix the torn ACL.
    • Laparoscopic surgery ข ˆ ’ The doctor will make 2 to 3 small cuts. A scope with a tiny camera is put through one of the small cuts to look at the knee. Your doctor will put small surgical tools into the holes to fix the ACL.
  • The doctor will close the cuts with stitches or staples and cover them with clean bandages.

What happens after the procedure?


  • You will go to the Recovery Room and the staff will watch you closely. Your will given drugs for pain if you need them.
  • Your leg will be propped up on pillows and you will have a large wrap around your knee.
  • Your doctor will tell you when you can go home. Often, you will go home the same day as the surgery.
  • You will have a brace on your knee to keep it from moving while it heals.

What drugs may be needed?


The doctor may order drugs to: ‚  
  • Help with pain and swelling
  • Prevent infection
  • Prevent blood clots

What problems could happen?


  • Infection
  • Bleeding
  • Blood clots
  • Injury to:
    • Other knee ligaments
    • Nerves
    • Blood vessels
    • Bone
  • Knee osteoarthritis
  • Breakage of graft, screw, or other fixations
  • Knee problems continue

What can be done to prevent this health problem?


  • When turning while walking, turn your whole body and not just your legs.
  • Wear the right equipment when playing sports. This includes protective equipment and padding.
  • Warm up slowly and stretch before you work out. Use good ways to train, such as slowly adding to how far you run. Do not work out if you are overly tired. Take extra care if working out in cold weather.
  • Strengthen your hip and thigh muscles to support your knee better.
  • Do not ignore or try to work through pain.
  • Stay away from strenuous activities when you cannot keep your balance.
  • Keep a healthy weight. Being heavy puts more stress on your knees. This makes them more likely to be hurt.

Where can I learn more?


American Academy of Orthopaedic Surgeons ‚  
http://orthoinfo.aaos.org/topic.cfm?topic=a00549 ‚  
http://orthoinfo.aaos.org/topic.cfm?topic=A00297 ‚  
KidsHealth ‚  
http://kidshealth.org/parent/medical/bones/acl_injuries.html ‚  

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚  

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