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Ligaments are the strong bands of fibrous tissue that connect bones to other bones, and hold together structures such as joints. Sometimes, when a ligament is damaged or torn, surgery may be required to reconstruct it, and perhaps the joint that it connects.
Anterior cruciate ligament (or ACL) reconstruction is ligament reconstruction surgery, which may be required after sustaining an injury to the knee.
The anterior cruciate ligament is one of the four strong ligaments in the knee joint which gives it stability. This ligament can be ruptured when the knee is twisted or forced forward; it’s a relatively common injury sustained during sports such as skiing, football, tennis and rugby.
Without surgery, the torn anterior cruciate ligament can fail to heal correctly, leaving the joint with inadequate stability and a possibility that further damage could be caused to the knee.
The operation to reconstruct a ligament will usually be carried out under a general anaesthetic, so you’ll be asleep during the procedure. The operation can take an hour or two; often you’ll be able to go home on the same day, but sometimes you may need to stay in hospital overnight.
The exact surgery you have will depend on the type, location and severity of the ligament damage. If the ligament is ruptured it may need to be reconstructed using a graft of tissue which is usually taken from the hamstring muscle tendons, or from part of the tendon below the knee cap.
These operations are usually carried out arthroscopically, using ‘keyhole’ techniques. This requires only a series of small cuts in the skin to allow the surgeon to see inside the joint and to carry out the procedure using small instruments. Compared with ‘open’ surgery, this technique reduces scarring and minimises recovery time.
Sometimes, when a ligament is damaged or torn, surgery may be required to reconstruct it, and perhaps the joint that it connects. Ligament reconstruction surgery may be required following an injury to a joint which has caused a ligament to rupture. Affected joints include ankles, shoulders, elbows and, particularly, knees.
You may have some pain after the operation which we’ll help you manage with painkillers. We’ll tell you how to care for your wound and, if you’ve had non-dissolvable stitches, we’ll make an appointment for you to have them removed.
A programme of physiotherapy will usually be suggested to help speed recovery. You’ll probably need some time off work, depending on the exact nature of your surgery. Your recovery time after an anterior cruciate ligament (or ACL) reconstruction, for example, is likely to be several months and perhaps up to a year before returning to play sports.