Knee injuries commonly occur for those involved in sports but can also happen if your leg or knee becomes twisted.

If your knee continually gives way after an accident or injury, it could be a sign that your anterior cruciate ligament (ACL) has ruptured – meaning a significant tear to the ligament that joins your thigh bone and knee joint. ACL reconstruction offers the chance of improving the stability of your knee in everyday life and sporting activities.

What is the anterior cruciate ligament?

The ACL is one of the important ligaments that stabilise your knee. If you have torn (ruptured) this ligament, the knee can collapse or give way when making twisting or turning movements. You may also find that you are unable to fully extend your leg, impacting your mobility.

How does an ACL rupture happen?

An ACL rupture happens as a result of a twisting injury to your knee. The common causes are contact sports and skiing injuries. You can injure other parts of your knee at the same time such as tearing cartilage or damaging the joint surface.

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Are there any alternatives to ACL reconstruction surgery?

Not all cases of a torn ligament will result in surgery. Physiotherapy can help you with exercises to strengthen and improve the co-ordination of the muscles in your thigh, whilst some people find wearing a knee brace can sometimes help while you are playing sports. However, we would recommend that you always seek advice from your consultant before returning to sports.

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ACL injuries and treatments

Consultant Orthopaedic Surgeon, Mr Sam Rajaratnam talks about Anterior Cruciate Ligament (ACL) injuries and the various treatment options available.

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What does the operation involve?

Your surgeon will make one or more incisions around your knee. They will usually perform the operation by an arthroscopy (keyhole surgery), using a camera to see inside your knee. The operation usually takes an hour to 90 minutes. Various anaesthetic techniques are possible, which you can discuss with the anaesthetist beforehand.

Your surgeon will replace the ACL with a piece of suitable tissue from another area of your body. The ends of the replacement ligament are fixed with special screws or anchors into holes drilled in the bone.

Two sources of replacement material for ACL reconstruction are commonly used:

  • Autografts (employing bone or tissue harvested from the patient's body)
  • Allografts (using bone or tissue from another body, either a cadaver or a live donor).

What complications can happen during surgery?

Complications of anaesthesia
Your anaesthetist will be able to discuss with you the possible complications of having an anaesthetic.

General complications of ACL reconstruction surgery
• Pain
• Bleeding
• Infection of the surgical site (wound)
• Unsightly scarring
• Blood clots
• Difficulty passing urine

Specific complications of ACL reconstruction surgery
• Break of the kneecap
• Damage to nerves around the knee
• Infection in the knee joint
• Discomfort in the front of the knee
• Loss of knee movement
• The knee keeps giving way
• Severe pain, stiffness and loss of use of the knee (complex regional pain syndrome)

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This document is intended for information purposes only and should not replace advice that your relevant health professional would give you.

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"I thoroughly recommend the Horder Centre. I had a day case ACL reconstruction, the staff are delightful the hospital very clean and super efficient. I felt like I was given the utmost care and had great confidence in every staff member who dealt with my case."
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Rehabilitation

The recovery process for the ACL is usually broken down into different phases of rehabilitation. Each phase has its own objectives, however, is intertwined with other phases since the goals are as progressive as the recovery itself. The rehabilitation process is at the pace of the patient and timelines are sometimes given to help give an idea of where one can be during rehabilitation. Timelines are not used to discourage or encourage those who aren’t ready to advance their recovery process. Such acts may cause serious injury or re-injury of the ACL.

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Guide price for self pay patients

Autograft Reconstruction of Anterior Cruciate Ligament

  Consultation Diagnostics Treatment Care after discharge
Hospital costs Included £350 £6330 Included
Consultant costs £220 Included Included Included
Estimated total cost  £6900
Estimated length of stay  1 night
*The guide price is correct as of 2nd March 2017

What's included

The prices in the table above (the “Guide Prices”) show what most patients should expect to pay at each appointment and on admission to hospital. The Guide Prices you pay might be different depending on your medical history and the type of implant you choose or your Consultant advises is best for you. Your price quotation will be made clear to you before you proceed with any tests, consultations or treatment.

Acknowledgements
Mr Stephen Milner DM FRCS (Tr. & Orth.)
Medical Illustration Copyright © Medical-Artist.com
Copyright © 2019 EIDO Healthcare Limited
The operation and treatment information on this webpage is produced using information from EIDO Healthcare Ltd and is licensed by the Horder Centre. The information should not replace advice that your relevant health professional would give you.