Our knees are among the most important and hardest-working joints we have. Consequently, they are also among the most vulnerable to injury. This is especially true for athletes who rely on them to support, carry, and absorb shock for the rest of the body during strenuous sports-related activities. Unfortunately, this means that the Anterior Cruciate Ligament (ACL) and many other parts of your knee are some of the most commonly injured structures for all types of athletes. When the injury is severe, ACL reconstruction surgery may become a necessary part of your treatment plan.
The prospect of knee reconstruction surgery can be scary, but Dr. Michael Rytel wants to dispel your fears and demystify the procedure should it become the best option for you. Here are four of Dr. Rytel’s most commonly-asked questions regarding knee reconstruction:
Why Might I Need an ACL Reconstruction?
Keeping in mind that 70% of all ACL tears are the result of non contact mechanisms, here are some of the most common actions that result in an athlete sustaining an ACL injury:
- Jumping and landing awkwardly
- Making a sudden stop
- Pivoting while your foot is planted in the ground
- Stopping and changing direction too quickly
- Direct trauma to the knee
Most knee reconstruction surgeries are performed for high-demand athletes, and for lower demand patients who have failed more conservative options. While some people can manage well following a conservative treatment of a torn ACL, a high grade ACL tear may require reconstructive surgery to help you return to full functionality. Here are some of the most common circumstances in which Dr. Rytel would recommend ACL reconstruction to you:
- You are a competitive athlete in a sport requiring frequent changes of direction who wants to return to competition.
- Despite conservative treatment consisting of physical therapy and brace wear, your knee buckles or gives way during normal activity.
- You have injured more than one knee ligament.
While many patients who undergo ACL reconstruction are young and capable of healing more quickly, age isn’t the most important factor in your decision to receive the surgery. Dr. Rytel will discuss your risk factors and benefits with you as part of developing your treatment plan.
How Does Reconstructive ACL Knee Surgery Work?
Your ACL is one of two ligaments in your knee, the Posterior Cruciate Ligament being the other. Together with the other ligaments of the knee, the ACL helps to maintain stability of the knee during times when you are changing direction or decelerating suddenly. Common things you might experience if you tear your ACL are:
- Feeling or even hearing a “pop” in the knee when the knee gives out.
- Having sudden, usually severe pain
- Finding that the knee is unstable when you try to get up.
- Inability to return to the sport -- not able to “walk it off.”
- A large amount of swelling which tends to occur within a few hours or less.
ACL reconstruction is an arthroscopic surgery during which a “new” ACL, referred to as a ‘graft,’ is placed in the knee to replace the one that is torn. The new ACL is harvested from an adjacent tendon or from a responsibly sourced donor. Small incisions are made through which the arthroscope and instruments can be placed into the knee. Tunnels are drilled in the femur (thigh bone) and tibia (leg bone). The ACL graft is then passed into the knee and secured within the tunnels. The graft as it heals then becomes the new ACL. The choice of graft depends on multiple factors, which Dr. Rytel will discuss with you if you require surgery.
How Do I Prepare for Reconstructive Knee Surgery?
Physical therapy isn’t just for after you’ve undergone surgery -- it’s also an important part of preparing to have your ACL reconstructed. Most preoperative physical therapy for knee surgery will last for several weeks with the goal of reducing the initial symptoms of an ACL tear, such as pain, swelling and loss of motion. This period of therapy will also serve to strengthen your muscles, which will help improve your range of motion after your surgery. Be sure to follow Dr. Rytel’s instructions regarding food and drink before your surgery, and don’t forget to let him know of any medications you’re taking. It’s also important to remember that in almost all cases, you’ll be under general anesthesia during your ACL reconstruction surgery. You’ll likely be able to go home the same day, but you’ll need someone to drive you!
How Long is My Knee Surgery Recovery Time?
Every patient is different, and ultimately, Dr. Rytel will provide guidance on the duration of your recovery. However, Dr. Rytel does employ minimally-invasive techniques -- such as arthroscopy -- to minimize your recovery time, reduce your pain, and shorten the amount of time you spend in the hospital or surgery center. Dr. Rytel will instruct you on how to manage any pain or swelling in your leg, but generally, keeping your leg elevated and frequently applying ice to the knee will be vital to your recovery. It is also likely that a brace and crutches will be necessary to support you and protect your knee as the graft settles into your joint.
It’s extremely important to remember that physical therapy is not an option! Full participation in physical therapy, including faithful performance of the home exercises given to you, is absolutely necessary to restore your range of motion, strength, and optimal function after surgery. Dr. Rytel will provide you with instructions and guidance at every step, helping you meet all of your recovery goals. Keep in mind that with maximum effort, it still usually requires 6-9 months to return to sport.
Dr. Michael Rytel is highly experienced in performing ACL reconstruction surgery and other minimally-invasive, cutting-edge orthopedic procedures. If you’re struggling with a knee injury, don’t hesitate to reach out or schedule an appointment online using our simple form!