The ACL, anterior cruciate ligament, is one of the most important stabilizers in the knee, consisting of a small band that crosses from the bottom, back part of the femur to the top, front part of the tibia bone.The ACL works with the posterior cruciate ligament (PCL), and the medial collateral ligament (MCL) to stabilize the knee by limiting rotational and forward movement of the tibia. Without these stabilizing structures in place, the stress from pivoting or stopping suddenly would cause you to collapse.
Many athletes suffer tears to the ACL. Players who compete in sports that involve turning, cutting, and pivoting motions such as football, soccer, or volleyball are often subject to injuries due to the lack of stability in their knees.
Injury to the ACL can be extremely severe and usually requires surgery. One popular treatment for a torn ACL is called an anterior cruciate ligament reconstruction. There are three different kinds of ACL reconstructions:
- Autograft: reconstructing the ACL with the patient’s own tissue from somewhere else in their body
- Allograft: replacing the ACL with someone else’s tissue
- Synthetic Graft: using artificial materials to restore the ACL
ACL Surgery Risks
Any surgery carries certain risks associated with it. For an ACL in particular, the risks are:
- Knee pain
- Stiffness in the knee
- A graft not healing well
- A graft failing or tearing after a return to physical activity.
Recovering from an ACL surgery will include:
- Pain Management: Medications, like opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and other local anesthetics will often be prescribed for short-term pain relief post-surgery. Your doctor may also recommend taking over-the-counter drugs, like aspirin or ibuprofen to lessen the risk of blood clots.
- Wound Care: Before you leave the hospital, you will learn how to change the dressing on your wound. Your medical team will also likely recommend to keep your knee raised on pillows, to ice it, and to wrap it in a bandage to keep it compressed.
- Walking Assistance: Following your ACL surgery, you will need to use crutches to take stress off the knee as it heals, and wear a knee brace to stabilize the joint throughout recovery.
- Rehabilitation Exercises: Completing rehabilitation exercises that are prescribed by either your surgeon or physical therapists will be essential to restore mobility and strength to your knee.
You will be able to recover from your ACL surgery within about nine months. For athletes, it can take up to 12 months to be able to participate in competitive play again.
The meniscus is a small piece of cartilage found twice in both knees that serve as shock absorbers and help distribute weight evenly across the knee, protecting the articular cartilage. Without the meniscus, weight can be unevenly distributed across the femur and tibia, which can lead to arthritis and bone death.
A meniscus surgery is an operation that removes or repairs either a completely torn or partially torn meniscus. Meniscus surgeries are common, especially among athletes who play sports that involve twisting, turning, or pivoting motions. Older adults are also more at risk to tear their meniscus due to the gradual weakening of the tendon over time.
Fortunately, not every meniscus injury needs surgery. The decision to get surgery depends on:
- Type, size, and location of the tear
- Your age
- Your level activity and lifestyle
- Related injuries (e.g., If your ACL is also torn)
- Severity of symptoms
Before recommending surgery, your doctor at Comprehensive Medical Care may suggest non-surgical treatments first, such as: physical therapy, medications, anti-inflammatory injections, or rest.
Benefits of Meniscus Surgery
Getting surgery for your meniscus tear can benefit you in a variety of ways, including:
- Improve mobility
- Return you to competitive sports and other activities
- Increase stability
- Hinder the development of arthritis
- Reduce pain
Meniscus surgery is a safe and common procedure that is low risk. Though rare, some complications include knee stiffness, nerve damage, or infection.
Meniscus Surgery Recovery
Similar to an ACL surgery, your recovery from a meniscus surgery will entail pain management, wound care, weight-bearing assistance, and rehabilitation therapy. Depending on how severe your meniscus tear was, your recovery will take one to three months.
A chondral injury, also known as an articular cartilage injury, may occur as result of a pivot or twist to the knee, similar to the motion that can cause a meniscus or ACL tear. Damage can also occur as a result of a direct blow to the knee or from a series of minor injuries that have accumulated over time.
A chondral procedure includes debridement, a process that cleans up worn, torn, or damaged portions of the chondral cartilage. Since torn or damaged cartilage is unable to heal itself, debridement is often necessary to encourage healing and restore normal knee function.
What to Expect From Your Chondral Procedure
Chondral procedures are performed using an arthroscope, which is a specialized kind of endoscope that is used to examine the interior of hollow structures. An arthroscope is attached to a fiber-optic video camera that may be inserted through the skin and soft tissue layers by making a very small surgical cut. After inserted, the view from the fiber-optic technology is transmitted to a high-definition video monitor.
Two main types of chondral procedures include microfracture and mosaicplasty, which are very similar, but not identical procedures.
- Microfracture: your doctor will drill small holes or fractures in the bone where the blood will then clot to develop new cartilage
- Mosaicplasty: when your doctor repairs the cartilage by transplanting the patient’s healthy bone and cartilage from non-weight bearing areas of the knee to treat the damaged areas of the knee
Chondral Procedure Recovery
Depending on the extent of your injury, and the kind of procedure that you recieve, recovery from a chondral procedure can vary significantly. Fortunately, microfracture and mosaicplasty surgical techniques are minimally invasive procedures that require less recovery time than traditional open surgeries.
Similar to an ACL and meniscus surgery, your surgery recovery will include pain management, wound care, rehabilitation exercise, and weight-bearing assistance devices, such as crutches or a brace. For these chondral procedures, it usually takes about three to six months for a full recovery.