ACLS

ACLS or Anterior cruciate ligament (ACL) surgery is performed to reconstruct or repair torn ACL. The anterior cruciate ligament is situated in the center of the knee joint, extending from the femur to the tibia. The surgery needs to be performed mostly in the cases of an avulsion fracture and in most cases, the autografts are used to replace the ligament during the surgery. The surgery is performed arthroscopically.

Details of Procedures:

Normally ACL gets injured when a twisting force is applied to the knee while the foot is firmly put on the ground or due to a direct blow to the knee while playing football or rugby.

The aim of the surgery is to restore the normal or almost normal stability and function of the injured knee. Surgery also saves the other knee structure from injury and degeneration. The surgery is advised to repair a complete or partial tear of the ACL when there is

  • Persistent instability of the knee post nonsurgical treatment and after the rehabilitation program
  • An active sportsman or a person’s work requires enough knee strength and stability
  • Chronic ACL deficiency, affecting the quality of life

Other associated symptoms may include

  • Changes in smell, taste, alertness, sensation-hearing
  • Motor function loss- bladder and bowel, balance, coordination, swallowing
  • Eye abnormalities-uncontrollable movements, different pupil size
  • Tremors in hands, difficulty in writing
  • Obesity
  • Symptoms due to pituitary tumor
  • Symptoms related to hormonal imbalance
  • Sensitivity to cold and heat
  • Low blood pressure

Symptoms of a torn ACL:

  • Severe pain at the knee soon after injury and /or an audible pop or crack sound
  • A sudden feeling of instability followed by huge swelling of the knee
  • Loss of strength, tenderness, restricted movement, and difficulty in straightening the leg fully
  • Positive signs in the anterior drawer test and Lachman’s test.

Facts & Figures:

  • Bonnet first discussed and mentioned ACL injury in medical literature in 1845.
  • 1 in 3000 individuals in the USA had anterior cruciate ligament injury and 100,00 injuries per year occur from snow skiing.
  • Female athletes are prone to get more ACL tear than male sportspersons.

Advantages

  • About 80-90% of patients are satisfied with the outcome and 60% resume work immediately after undergoing the ACL surgery.
  • Patients seeking an anterior cruciate ligament repair through medical tourism mostly return in 1-2 days.
  • ACL repair is done arthroscopically, so the need for a hospital stay.

Disadvantages

  • Improper healing may call for revision ACL reconstruction
  • Limited exercises of thigh muscles post-surgery for some time.
  • Postoperative stiffness with limited mobility of the knee.

Preoperative Preparation

  • Complete physical examination
  • Blood and urinalysis
  • ECG and x-ray chest for the patient above 50 years
  • Consult with the surgeon week prior and get the correct medicinal prescriptions.
  • Inform the surgeon about smoking and alcohol habits.
  • Plan for leave from work and domestic help at home.
  • Don’t consume anything after midnight before surgery.

Post operative care

  • A continuous passive motion device may be applied to patients that must be used while sleeping for the first two weeks.
  • Physiotherapy starts2-3 days post-surgery. Follow the rehabilitation program rigidly and correctly for the best results.