Mr Rodney Richardson
MBBS FRACS (Ortho) FAOrthA

Specialising in Surgery of the Knee

Knee Reconstruction

Anterior Cruciate Ligament Reconstruction

The anterior cruciate ligament is one of the major ligaments stabilising your knee. Unfortunately, it is also one of the most common ligaments to be injured.

It is an essential stabiliser of the knee when running and turning at speed, or cutting or twisting activities are performed. As a result it is commonly injured in sports such as football or netball. It can occur when tackled or landing awkwardly from a jump position. A “popping” sensation is often felt, along with acute pain and swelling.

The pain may settle quickly, followed by the swelling which may take a few weeks, but remains unstable when activities are resumed. The sensation of the knee giving way is often experienced, and the risk of further injury is high.

If instability exists or you have a desire to continue playing sports in which it can be predicted that you will have instability, then a knee reconstruction may be suggested.

A knee reconstruction involves the replacement of the torn ligament with a “new” one. This typically comes from a couple of hamstring tendons, or the middle 1/3 of the patella tendon. Other grafts are available if required. Mr Richardson will decide on what is the most suitable graft for your knee, after discussing the options with you at the time of your consultation.

A Knee reconstruction will give you a 90% chance of returning to the level of activity you were at before your injury.

Operative procedure

You will be admitted for your reconstruction on the day of surgery. Mr Richardson performs the operation arthroscopically, which allows the rest of the knee to be examined at the same time, and any intra-articular pathology identified. Meniscal tears may be repaired, or resected, loose bodies removed, or chondral damage treated.

The procedure takes approximately 1 hour.

Initial Post-Operative period

After surgery you will have an ice pack applied to your leg in recovery. This helps with pain, and swelling. You will be encouraged to use ICE intermittently for the first week after your surgery as it help with pain and swelling. Physiotherapy commences immediately to regain quadriceps strength, and assist you with mobilisation.

A splint which maintains your knee in extension is applied for two weeks, after which it is removed, and with the assistance of a physiotherapist, range of movement is regained. During this period you are able to fully weight bear on your operated leg.

Most patients will be discharged 24-48 hours after surgery.

Post-operative Rehabilitation

Ongoing physiotherapy is an essential part of your recovery. An intensive programme will be undertaken until you regain a full range of motion and good quadriceps strength. A gradual return of activities is encouraged as your new graft becomes incorporated, and regains its strength.

As a guide, walking, cycling and swimming are allowed, as soon as the wounds are healed (2 weeks). Jogging is allowed at 3 months, with light sporting activities at 6 months. Return to contact sports, or those requiring twisting, or cutting movements is allowed at 12 months post-operatively.

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