ACL Reconstruction

English

جراحة إعادة بناء الرباط الصليبي الأمامي

Indications:

This is done for patients with ACL tear and an unstable functional Knee.

Description:

Replace the torn Anterior Cruciate Ligament of the Knee “Known as ACL” with Hamstring tendon graft of the same knee. Tendon graft harvesting done through a 2 cm incision over the upper leg. Procedure is done all arthroscopically.

Expected time of surgery:

1 hour

Implants used:

2 Bioabsorbable Interference screws (Mitek, USA)

Types of anaesthesia:

Spinal/General

Hospital stay:

1 day

Post operative plan:

The patient weight bears on the night of surgery with his knees in an immobilizer. Range of motion is started promptly

acl-reconstruction-hamstring-graftACL Reconstruction

Meniscal procedures 01Meniscal procedures 02Meniscal procedures 03

Post-Operative Instructions
ACL Reconstruction

Post-operative Day 1

  • Do not put any creams or antibiotic agents on the wounds.
  • You can shower – but don’t get the dressing wet – just wrap it with a plastic cover and plaster it around the bandage to seal it for the first 10 days.
  • After the 10th day you can remove the dressing and have your shower. Pat dry the wounds after the shower. Put band-aids over the wounds after the shower.
  • You should be actively contracting your quadriceps muscle (squeezing your thigh muscle by pushing your knee straight) – this should be done as much as you possibly can.
  • You should be trying to actively raise your leg straight in the air (while sitting down or lying down) – this can be done initially with the brace on but should be done with the brace off, for example after you come out of the shower.
  • The brace will stay in the “locked” position (straight) until you return to our clinic.
  • You should sleep with a pillow under the HEEL (not the knee) to help with keeping the knee straight – this should be done for the entirety of the brace wear.
  • You can put down as much weight as possible on your foot – unless specifically instructed not do so if you have an additional procedure besides the ACL reconstruction (for example, a meniscal repair, or surface cartilage procedure).
  • Use your cryotherapy (Ice bags) as instructed to decrease swelling and diminish pain.

Post-operative Days 2-7 (1st Post-operative visit)

  • Continue as above.
  • You will have your 1stpost-operative visit somewhere in this time period (7-10 days after surgery).
  • At that visit, we will change your dressings (streri-strips), remove your stitches (if necessary) and inspect your wounds. Several small sutures are snipped at the skin level (does not hurt!).
  • If you are able to perform a straight leg raise we will allow you to start unlocking the brace for walking. This is important because it typically means you’ll be able to get off the crutches sooner.
  • You will still sleep with your brace locked in extension for a total of 4 weeks after surgery.
  • We will review your arthroscopic photos to show you what was done at your surgery.

Post-operative Weeks 1-6 (2nd Post-operative visit between 4-6 weeks post-op)

  • You will sleep with the brace locked in extension for 4 weeks.
  • You can typically stop using the crutches between 4-6 weeks post-operatively.
  • You can stop using the brace after 4 weeks post-operatively.

Range of Motion (ROM) Exercises

I-Extension on a bolster (below)

While sitting or lying down with the brace off, support your heel on a towel roll. Now let your knee straighten as much as possible. To increase the stretch you may activate your quadriceps muscle or apply some pressure (your hands or weight) on the thigh, but not over the knee cap. You should feel some stretching and mild discomfort behind the knee. Hold this stretch for 1-5 minutes, rest for 30-60 seconds, repeat 3-5 times consecutively, and perform 3-5 sessions per day.

ACL Post Operation Instructions 01

II-Heel slides with assist (below)

Lie on your back with your brace off and slowly slide your foot toward your hips, as far as possible. You may use your other foot to push for greater motion. At this point it is normal to feel pressure in the front of the knee. Hold this for 5-10 seconds, Now slide the foot back until the knee is fully extended. Repeat 15-25 times, and perform 3-5 times per day.

ACL Post Operation Instructions 02

III-Seated knee flexion (below)

Sit with your leg off the edge of a table or chair. Your brace should be off. Allow the knee to bend as far as possible. At first you may need to use the opposite leg to help slowly lower the foot. Then use the uninvolved foot to apply a little overpressure over the foot, trying to bend it further. At this point it is normal to feel pressure in the front of the knee. Hold this for 5-10 seconds, Repeat 10-20 times, and perform 3-5 times a day.

NOTE: It is necessary to do exercises to increase knee flexion. The previous three exercises all work on increasing knee flexion. If there is one that works better for you, you may do that exercise more often and spend less time on the other flexion exercises. They should be done with your brace off.

ACL Post Operation Instructions 03

FREQUENTLY ASKED QUESTIONS (FAQ)

  • When can I remove the brace?

You can take the brace off for showering on post op day 1 and to do your exercises with physical therapy. However, you must wear the brace at all other times until your first post-operative follow-up visit, at which time we will discuss this further.

  • When can I begin driving?

Typically, you will be able to resume driving ~2-4 weeks post-operatively depending on how quickly you heal after surgery.

  • When can I return to work?

This really depends on the individual patient specifically with respect to job demands (labor vs desk job). Some patients return to work as soon as 4-7 days post-operatively and others require extensive time away from work if “limited duty” is not available.

  • How long will I have Physical Therapy after the surgery?

The typical therapy program will be a minimum of 6 months. The 1st phase of therapy will be designed to safely regain your range of motion while the 2nd phase of therapy will be directed at regaining function, strength, and endurance.

  • Why is my knee “leaking”?

Remember that arthroscopy is performed by pumping in a lot of fluid into the knee and this fluid then escapes through the small incisions (portals) – this is entirely normal to occur after surgery.

  • When should I call the office with concerns?

Any signs of infection should be reported immediately – these include increased drainage (usually thick, cloudy, not liquid secondary to the arthroscopy), redness, increased warmth, and fevers.

We hope for you full and rapid recovery

Help & inquires

للمساعدة والأسئلة

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Clinic Address

30 Mourad St. – Giza
2nd Floor – # 108
RadioShack building

Tel: 3578909
Mobile: 010 60906808

Clinic Schedule:

Saturday, Monday & Wednesday:
from 4 pm to 7 pm

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    عنوان العيادة

    30 شارع مراد – الجيزة
    الدور الثانى – عيادة رقم 108
    عمارة راديوشاك

    تليفون: 35738909
    محمول: 01060906808

    مواعيد العيادة

    السبت والأثنين والأربعاء
    ٤-٧ مساء