ACL reconstruction is surgery to replace a torn anterior cruciate (KROO-she-ate) ligament (ACL) — a major ligament in your knee. ACL injuries most commonly occur during sports that involve sudden stops and changes in direction — such as soccer, football, basketball and volleyball.
Ligaments are strong bands of tissue that attach one bone to another bone. During ACL reconstruction, the torn ligament is removed and replaced with a band of tissue that usually connects muscle to bone (tendon). The graft tendon is taken from another part of your knee or from a deceased donor.
ACL reconstruction is an outpatient surgery that’s performed by a doctor who specializes in surgical procedures of the bones and joints.
Why it’s done
Anterior cruciate ligament
The ACL — one of two ligaments that crosses the middle of the knee — connects your thighbone to your shinbone and helps stabilize your knee joint.
Most ACL injuries happen during sports and fitness activities that can put stress on the knee:
Suddenly slowing down and changing direction (cutting)
Pivoting with your foot firmly planted
Landing from a jump incorrectly
Stopping suddenly
Receiving a direct blow to the knee
A course of physical therapy may successfully treat an ACL injury for people who are relatively inactive, engage in moderate exercise and recreational activities, or play sports that put less stress on the knees.
ACL reconstruction is generally recommended if:
You’re an athlete and want to continue in your sport, especially if the sport involves jumping, cutting or pivoting
More than one ligament is injured
You have a torn meniscus that requires repair
The injury is causing your knee to buckle during everyday activities
You’re young (though other factors, such as activity level and knee instability, are more important than age)
Risks
ACL reconstruction is a surgical procedure. And, as with any surgery, bleeding and infection at the surgical site are potential risks. Other risks associated with ACL reconstruction include:
Knee pain or stiffness
Poor healing of the graft
Graft failure after returning to sport
After the procedure
Once you recover from the anesthesia, you can go home the same day. Before you go home, you’ll practice walking with crutches, and your surgeon may ask you to wear a knee brace or splint to help protect the graft.
Your PHYSIOTHERAPIST will give you specific instructions on how to control swelling and pain after surgery. In general, it’s important to keep your leg elevated, apply a cold wrap or ice to your knee, and rest as much as possible.
Follow your PHYSIOTHERAPIST advice on when to ice your knee, how long to use crutches and when it’s safe to bear weight on your knee. You’ll also be told when you can shower or bathe, when you should change dressings on the wound, and how to manage post-surgery care.
Progressive physical therapy after ACL surgery helps to strengthen the muscles around your knee and improve flexibility. A physical therapist will teach you how to do exercises that you will perform either with continued supervision or at home. Following the rehabilitation plan is important for proper healing and achieving the best possible outcomes.
DAY 1 TO WEEK 4
PAIN MANAGEMENT( ICING , ELEVATION, MEDICATION )
IMMOBILIZER APPLIED FOR BOTH OPEN AND ARTHROSCOPIC CASE
ambulation with crutches
muscle setting exercises
ROM started from the very first day in ARTHROSCOPIC CASE while after 15 days in open ACL.
stitch removal after 15 days.
isometric quadriceps , hamstrings ,adductors at multiple angle
WEEK 4 TO WEEK 10
Multiple angle isometrics .
closed chain strengthening and PRE.
ACHIEVED FULL ROM.
endurance training
stabilization exercises, elastic bands , band walking
no assistive device after 4th week.
week 11 to 24
stretching LE
ADVANCED CLOSED CHAIN EXERCISE
ADVANCED PROPRIOCEPTION EXERCISES.
SPORTS ACTIVITIES AFTER 12TH MONTH