You may have heard about a professional athlete who suffered a torn ACL while playing football or soccer. This type of injury can prevent professional athletes from participating in their sport until after they have recovered. But did you know that an ACL tear can happen to you, too? In fact, an ACL injury is a common type of knee injury that can occur while playing sports, from a car accident, or due to a slip and fall accident. An ACL injury can be quite serious, and you will typically need to see an orthopedic surgeon for a thorough diagnosis and treatment plan.
Many people who suffer a torn ACL will need to undergo ACL surgery, especially athletes who want to return to their sport as soon as possible. While there are some situations where surgery may not be necessary, treatment for an ACL injury should always happen as soon as possible to ensure you haven’t suffered additional damage to the area. If left untreated, an ACL injury can cause complications and may even make you susceptible to other knee injuries in the future. If your orthopedic surgeon recommends ACL surgery, then here are some things you need to know about the procedure and what to expect.
What Exactly Is the ACL?
ACL stands for anterior cruciate ligament and is one of the key ligaments in your knee. The ACL and another ligament, known as the posterior cruciate ligament, or PCL, help your knee move back and forth. You also depend on your ACL for stability in the knee joint. The ACL connects the back of your thighbone to the front of your shinbone, supporting movements like bending and straightening your knee. When your ACL functions properly, it helps prevent your knee from becoming hyperextended, or stretching beyond its typical limits.
Types of ACL Injuries
Damage to the ACL is categorized in grades 1-3, depending on the severity. A strain refers to a stretching or tearing of ligaments that connect two bones together. These tough bands of fibrous tissues can help support movements and joints throughout the body, including the ACL in your knee. Here are the three types of ACL injuries, from mild to severe.
Grade 1 Sprain
A Grade 1 sprain refers to an overstretched ligament where no tearing has occurred. A mild sprain of the ACL in your knee might cause some pain and tenderness, especially when bending or straightening the knee. This is the mildest form of ACL injury and can typically be managed with a combination of home remedies and working with your orthopedic doctor.
Grade 2 Sprain
A Grade 2 sprain refers to when the ACL becomes overstretched and suffers some damage, also known as a partial tear. This type of ACL injury may cause some instability in the knee, though you may still be able to bear weight and get around. A Grade 2 sprain or partial tear of the ACL is the least common type of ACL injury. You may not need surgery for a Grade 2 sprain of the ACL, and your orthopedic surgeon may recommend physical therapy to help you recover.
Grade 3 Sprain
A Grade 3 sprain is a complete tear when the ligament tears in two pieces and can no longer provide any stability to the knee joint. Because this ligament runs through the knee joint from back to front, it can also lead to further joint and tissue damage. The ligament may also separate from part of the bone with a Grade 3 sprain or complete ACL tear.
Common Causes of an ACL Tear
ACL tears are more common in athletes and highly active people. Certain activities can put you at higher risk for an ACL injury, like overextending the knee joint, changing directions too fast, or landing flat-footed from a jump. When you change your direction or speed while moving quickly, you can put too much pressure on the ligaments in your knee. An ACL tear can also occur in someone who has been in a car accident or from a slip-and-fall injury. A blow to the side of the knee can lead to an ACL injury ranging from mild to severe.
When Might You Need ACL Surgery?
If you suffer a Grade 3 sprain of the ACL, you will typically require ACL surgery. Any type of ACL injury should get checked out by an orthopedic surgeon, and a complete tear of the ACL usually requires surgery. The orthopedic surgeon will perform a physical exam and test your knee’s stability and range of motion. They may also run some tests like an X-ray or MRI to get a better look at the damage to the knee and surrounding area.
Symptoms of an ACL Tear
The most common symptoms of an ACL tear include pain, tenderness, and swelling around the knee. If you suffer a complete ACL tear, you may hear a popping sound or feel a strange pulling sensation right when the injury occurred. A complete ACL tear would cause you to lose stability in the knee joint, so you may not be able to bear any weight on the knee. When you try to stand or walk, you may feel like your knee is giving out from underneath you.
What Happens with ACL Surgery?
An ACL surgery is also referred to as an ACL reconstruction and typically takes place in an outpatient setting. An orthopedic surgeon will perform ACL surgery because this type of doctor performs surgeries on bones and joints. When you undergo ACL surgery, you will typically get general anesthesia, which means you will be unconscious during the surgical procedure. The orthopedic surgeon will make small incisions around the knee to insert the surgical instruments necessary to complete the procedure. Then, the surgeon will remove the damaged ligament and replace it with new tissue, called a graft. Most replacement tissue for an ACL surgery comes either from another part of your knee or from a deceased donor. The surgeon will secure the graft to the bones with screws or other devices, and this will create scaffolding where the new ligament can grow.
Tips to Prepare for ACL Surgery
Before you go through ACL surgery, your orthopedic surgeon will talk you through how to best prepare for ACL surgery, what to expect from the actual procedure, and what the recovery process will look like. Here are some tips for how to best prepare for ACL surgery:
Talk to Your Orthopedic Surgeon
You should feel comfortable talking to your orthopedic surgeon about all your options, including the details of your injury and why ACL surgery is recommended in your case. The more you know about your injury and treatment, the more comfortable you will be with the process. As you prepare for surgery, you want to have an orthopedic surgeon you trust and who can ask questions as necessary throughout the process. You will also need to talk to your orthopedic surgeon about your current life circumstances, including how the injury may impact your home and work responsibilities. Let your surgeon know about what medications you take and provide them with a full medical history.
Write Down Your Questions & Concerns
As you prepare for ACL surgery, it is completely common to have questions and want to voice concerns. Write down questions and concerns as you think of them so you can bring them to your appointment with your orthopedic surgeon. That way, you don’t have to worry about remembering once you get to the office. This will also help you keep a record of the answers to your questions, and you may want to save this information as part of your personal medical records. Documenting your experience can also be helpful if you suffered an injury during a car accident and need additional information for a claim or legal proceeding.
Take Care of Yourself Before Surgery
You want to take care of yourself as best as you can before surgery. This means staying off your knee if the doctor recommends it and avoiding circumstances that could accidentally make your injury worse. You want to go into the surgery as healthy as possible to have a better outcome and shorter recovery. When you focus on getting or staying healthy before surgery, this has been shown to support an easier recovery and decrease the risk of complications that could arise during surgery. For example, you may want to quit smoking before undergoing a procedure like ACL surgery.
Plan for the Recovery Process
Recovery from an ACL surgery will require you to stay off the affected leg for several weeks at a time. This will likely impact your regular routines and activities both at home and work or school. To help you manage the recovery process, you will want to plan ahead. Recognize that you may not be able to do typical things like cook, clean, or drive your vehicle, so you may need assistance around the house. Check-in with family members or neighbors for help with common tasks like taking your dog for a walk or doing yard work.
Practice Walking with Crutches
After surgery, you won’t be able to put any weight on the affected leg for multiple weeks. This means you will likely use crutches to get around when necessary. If you have never used crutches before, then you want to practice walking with them. Crutches can take some getting used to, so you want to practice typical routes through your home, like getting from the bedroom to the bathroom to the kitchen. In some cases, you may need to rearrange furniture or move obstacles in your home so you can move around easier.
Practice Calming Exercises
Part of planning for an ACL surgery is preparing yourself mentally for the task ahead. The more information you gather from your orthopedic surgeon, physical therapist, and other supportive staff, the better you will feel. Before going into the surgery, you may want to have some relaxation techniques in mind, like calming exercises or meditation practices. Do what you can to ease anxiety and stress before the surgery to help the procedure go smoothly and so you can feel better prepared for what comes next.
What to Expect with ACL Surgery Recovery
Immediately after an ACL surgery, you can typically expect to go home the same day. Your orthopedic surgeon will check on you and likely walk you through practicing how to walk with crutches and how your knee brace or splint will work. They will provide you with detailed instructions on managing your pain and swelling after surgery. They will also talk to you about your options for pain medication, ranging from over-the-counter medications to prescription pain medications. If your doctor prescribes opioids, it will typically only be for a short period of time to avoid side effects and the risk of addiction.
The recovery process after an ACL surgery will take up to six months of physical therapy on average. You will work with a physical therapist after ACL surgery to help you regain leg strength and full range of motion. Progressive physical therapy will help you gently and safely increase the degree to which you can bend your knee, then move on to other exercises and techniques to improve your strength, flexibility, and mobility. Full recovery from an ACL surgery can take an average of 9 months.
Talk to our team of Conyers doctors at AICA Orthopedics to learn more about how we can help you prepare for ACL surgery and recover afterward. Our team of doctors includes orthopedic surgeons, physical therapists, chiropractors, and more who work together to provide you with a multi-disciplinary approach to diagnosing and treating health conditions. We can diagnose your ACL injury and talk you through all your options for treatment, including whether surgery is the right choice for you. Visit our AICA clinic in Conyers and get started on recovery and rehabilitation from an ACL injury and surgery today.