ACL injury: Operative Treatment plan and Post-Operative Care

An ACL injury is a common knee injury that affects athletes and physically active individuals. An ACL injury may require operational treatment to repair or reconstruct the damaged ligament in severe cases. An operative Treatment plan and Post-Operative Care for ACL injury are critical for successful recovery. These patients need anti-inflammatory medications to manage pain and swelling and a rehabilitation plan to return to everyday life gradually. 

ACL Injury

An ACL injury is a common knee injury. A specific ligament in the knee supports, strains, or tears the joint. These kinds of pain occur from sudden twisting or rating motion. It can also occur from a direct blow to the knee. For the treatment of ACL Injury, the specialist suggests two treatment plans based on the patient’s condition, thus are- operative and Non-Operative. Here we focus on the Operative Treatment Plan and the Successful Recovery Process after the Operation.

Operative Treatment Plan

Surgery 

ACL injuries can treat with surgery if the patient is active. And wants to resume sports or other high-impact activities. ACL reconstruction surgery aims to replace the damaged ligament with a new one.

The surgery involves the following steps:

Anesthesia: The patient will give general anesthesia to put them to sleep during the surgery.

Arthroscopy: Small incisions will make around the knee. And an arthroscope[1] (a small camera) inserts to visualize the joint. The surgeon can then see the ACL and assess the extent of the damage.

ACL injury: Operative Treatment plan and Post-Operative Care
Figure: Arthroscopy

Graft preparation: A tissue graft[1] needs to replace the damaged ACL. The most common type of graft is a piece of the patient’s tissue called an autograft. The most common autografts are the patellar tendon or hamstring tendon.

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ACL injury: Operative Treatment plan and Post-Operative Care

Graft insertion: The surgeon will drill small tunnels in the thighbone(Femur) and shinbone(Tibia). Then thread the graft through these tunnels. The graft is then secured in place with screws[1] or other fixation devices.

ACL injury: Operative Treatment plan and Post-Operative Care
Figure: Graft Insertion

Closing the incision: The incisions close with sutures or staples. A bandage applies to the knee.

ACL injury: Operative Treatment plan and Post-Operative Care
Figure: Closing the incision

Recovery from ACL surgery takes several months. It is an essential part of the recovery process. It will regain strength and stability in the knee. And also regains range of motion, power, and endurance. It’s important to note that recovery can vary depending on the patient—the severity of the injury and the type of surgery.

Post-Operative Care Procedure for ACL Injure Operative Patient

Medication

Medication[2][3] can use to treat an ACL injury to help manage pain and inflammation. The types of medication that may prescribe include

  • Non-steroidal anti-inflammatory drugs (NSAIDs):  These medications, such as ibuprofen and naproxen, help to reduce pain and inflammation. They are available over the counter or by prescription.
  • Acetaminophen: This medication, also known as paracetamol, can also use to reduce pain. It is available over the counter.
  • Narcotics: If the pain is severe, these medications are usually only used for a short period. They should use with caution as they can be habit-forming.
  • Steroids: Corticosteroid injections can reduce inflammation and pain, such as – Triamcinolone or methylprednisolone.
  • Muscle relaxers:  Medications such as cyclobenzaprine or carisoprodol may prescribe. 

It’s important to note that medication is only one part of the treatment for an ACL injury. Physical therapy, rest, and a proper rehabilitation program. And in some cases, surgery is also an essential component of treatment.

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Rehabilitation

It is an essential part of the treatment process for an ACL injury, whether or surgery performs. Rehabilitation[1][4][5] aims to help the patient. It helps to regain strength, stability, and range of motion. Its function in the affected knee.

The rehabilitation process involves the following steps:

Initial phase: This phase usually lasts a few days to a week after the injury. The focus is on reducing pain and swelling and regaining the range of motion in the knee. This may involve using modalities such as ice, heat, ultrasound, and electrical stimulation.

Strengthening phase: This phase begins once the knee has improved enough. The focus is on regaining strength and stability in the knee. Quadriceps, hamstring, calf strengthening, and proprioception exercises help.

ACL injury: Operative Treatment plan and Post-Operative Care

Sport-specific training: It begins once the knee has regained strength and stability. The focus is on improving the power and endurance of the knee. And the functional ability through sport-specific drills and exercises.

Return to activity: This phase begins once the patient has regained a good level of function. The focus is helping patients return to their pre-injury activity levels. Such as sports or work.

It’s important to remember that the rehabilitation process will customize. It defines each patient’s needs. Objectives because of the time it takes to recover from an ACL injury. It can vary depending on the patient, the severity of the injury, and the type of surgery.

An ACL injury is a significant knee injury that may require surgical intervention for effective treatment. The operative treatment plan for ACL injury involves repairing or replacing the damaged ligament, and post-operative care focuses on proper rehabilitation for a successful recovery. Effective post-operative care, including physical therapy, rest, and a gradual return to physical activity, is crucial for avoiding complications and achieving optimal outcomes.

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Reference

Anterior Cruciate Ligament Injury: Conservative Versus Surgical Treatment

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8730351/

2. Is it worth performing initial non-operative treatment for patients with acute ACL injury?: a prospective cohort prognostic study

https://kneesurgrelatres.biomedcentral.com/articles/10.1186/s43019-021-00094-3

Dr. M Shahadat Hossain
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Physiotherapist, Pain, Paralysis & Manipulative Therapy Specialist, Assistant Professor Dhaka College of Physiotherapy, Secretary-General(BPA), Secretary(CARD), Chief Consultant(ASPC), Conceptual Inventor(SDM), Faculty Member(CRP), Member-Bangladesh Rehabilitation Council

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