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ACL  Reconstruction

ACL reconstruction is a type of arthroscopic procedure in which a graft is put as a replacement for the damaged Anterior cruciate ligament (ACL)

The bony structure of the knee joint is formed by Femur (the thigh bone)  Tibia ( the shin bone )and the Patella .The ACL(Anterior cruciate ligament) is one of the four main ligaments which helps to connect the femur to the tibia thus helping in maintaining the stability of knee.

 

In the following sections you will know about:

  1. Types and procedure for ACL reconstruction
  2. Cost of ACL reconstruction
  3. Diagnosis and tests requiring ACL reconstruction
  4. Leading doctors and hospitals for ACL reconsturction
  5. Frequently asked questions about ACL reconstruction surgery

Treatments and Cost Related to ACL Reconstruction

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ACL Reconstruction Cost In India For A Patient From United States Change Selection

No. of Travellers 2
Days in Hospital 5
Days Outside Hospital 12
Total days in India 17
Treatment Cost USD 3,200

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Procedure of ACL Reconstruction

1.Selection of Graft

The surgical ACL reconstruction is done using grafts ,these grafts maybe

Autografts –tendons from patients own body usually

  • Quadriceps tendon graft or
  • Hamstring tendon  graft or
  • The patellar tendon graft

 

Allograft – tendons taken from the deceased donor .

Usually autografts are preferred over allograft as the likelihood of rupturing again is minimal  as also the chances of secondary infection less and Hamstring tendon autograft has an added advantage that it regenerates over time making the graft more stable.

 

2.During the surgery

  • The surgeon will make around 2-3 small incisions  around the damaged knee
  • An arthroscope that is a thin tube fitted with a fibre optic camera  which allows the surgeon to see inside the knee clearly  is inserted through one of the incision .
  • First of all the torn ACL is removed and the area is cleaned
  • Through the other incision surgical drills are put in and small holes are made into the femur and the tibia.
  • The graft is then passed through these holes and held in place with screws or plugs or staples
  • During the surgery if the surgeon feels the other ligaments , tendons , cartilage of the knee are also damaged he may repair them .
  • Incision in skin then closed with stitches or staples

 

3.After surgery

Care is to be taken to keep the incision area dry and clean to avoid infection .

You may need to wear a knee brace for 1-4 weeks  as also you will need physical rehabilitation to help gain back the stability and function of the knee joint which may take around 4-6 months.

 

Symptoms presented by patient of ACL Rupture are

  • Severe Pain
  • Swelling in the injured knee  ,
  • Loss of stability while walking and loss of motion range
  • Many hear or feel a Pop in knee when ACL injury occurs

 

Diagnosis and tests for ACL Reconstruction

It is important to have accurate diagnosis and knowledge severity of injury

Clinical examination

 Physical examination is done to understand the type of injury wherein the doctor will access the function of knee joint by moving it in different positions.

Pivot shift test

One of the main tests to understand ACL injury or laxity , it tells about the unstability. If test is positive a subluxation will occur at 20 to 40 degree of flexion which shows ACL damage. 

Anterior drawer test

Clinically done in cases of suspected  cruciate ligament rupture, the patient is made supine , with hip flexed at 45 degree , knee flexed to 90 degree, hamstring relaxed, and then pulled posterior to anterior direction, excessive displacement of tibia anteriorly suggests that ACL has a potential tear.

Lachman test

Also clinically performed by the orthopedician to diagnose rupture of anterior cruciate ligament, if the test is positive there will be increased forward/upward  movement of tibia and a significant  soft end point when this movement ends.

 

Medical Investigations For ACL Reconstruction

  • X-ray to rule out fracture
  • MRI to evaluate ACL injury and also to see if there is more damage to other knee ligaments , tendons
  • Routine tests to declare you fit for surgery

 

Factors affecting the Cost of ACL Reconstruction surgery

Following are the factors which will affect the treatment cost:

  • The hospital the patient is opting for.
  •  Room –Standard single room, deluxe room, super deluxe room for the number of nights specified (including nursing fee, meals, room rate, and  room service).
  • Operating room, ICU charges
  •  Fee for the team of doctors (Surgeons, Anesthetist, Physiotherapist,Dietician).
  •  Medicines
  • Standard test and diagnostic procedures
  •  Cost of the follow –up care which is required after the procedure.
  • Hospitals in India provide ACL –reconstruction treatment at a cost that comfortably comes under the patient budget.

 

Recovery  from ACL Reconstruction

Patient may have to wear a knee brace for the first 1 to 4 weeks & may need to wear crutches for 1 to 4 weeks. A follow-up appointment with the doctor or surgeon will be within a few weeks of surgery. Complete recovery will often take 4 to 6 months.

 

ACL Reconstruction Procedure: 4:15Min

 

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FAQs about ACL Reconstruction surgery

What are the main reasons for ACL Rupture?

It is the most common ligament injury of the knee seen in sportsperson mainly happens while sports or other high intensity physical activities that put pressure on knee, or as a result of direct injury to knee , jumping and landing incorrectly , suddenly reducing pace and changing direction of movement simultaneously.

 

Do all the ACL tears require surgery ?

Not all ACL tears require surgery , BUT

  • if have a complete ACL tear
  • if you are a sports person  and require knee strength as your occupation
  • have also injured other parts of the knee
  •  have already undergone  physiotherapy and rehab without much     improvement in pain and joint stability .

 

Is ACL Reconstruction surgery risky procedure ?

  • No it’s a safe surgery, but complications may arise like
  • Infections
  • Blood clotting in legs
  • Damage to other vessels , nerves during surgery
  • In some patients screws may cause problem and require removal
  • In some they may be a problem in graft tendon 

 

What are the factors on which the success of surgery depends ?

Successful ACL surgery depends on many a factors but the significant ones are selection of graft , placement of graft  in bone tunnel and fixation of the graft as also the post operative rehabilitation .

 

Can ACL injuries be prevented ?

Yes by doing strengthening exercises of the core muscles ,and wearing proper  sports gear  to prevent sport injury, improve jumping and landing techniques.

 

How long after ACL Reconstructive surgery can I return to sports ?

Usually it takes 8-12 months alongside physical rehabilitation to fully recover to be able to get back to sports.

 

What are the long term success rate of ACL reconstructive surgery ?

 ACL reconstructive surgery is a very common surgery and the success rate for these surgeries is around 80-90 %

 

 

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