Arthroscopy & ACL Reconstruction (Knee)

What is Arthroscopy and how is it useful in repairing anterior cruciate ligament (ACL) injuries to the knee?

In anterior cruciate ligament reconstruction, a doctor can use fine instruments which are passed into the joint via an arthroscope and into the knee in order to reconstruct torn ligaments. An anterior cruciate ligament (ACL) injury is caused by extreme stretching and tearing of the anterior cruciate ligament in the knee. An arthroscope is like a thin telescope with a light source used to magnify the structures inside the knee allowing evaluation and treatment.

How is it done?

ACL reconstruction generally takes between one and two hours and is performed under general anesthesia, which means you will sleep through the surgery, or spinal block. Patients can have varying diagnoses and pre-existing conditions. Surgeries vary widely and are patient specific. The most common method of ACL repair utilizes a segment of tendon which is removed and then grafted in the same position as the damaged ACL. A three to five inch incision is made in the knee in order to harvest the ligament graft. The rest of the operation is done arthroscopically. The old ACL tissue is removed and the new tendon is pinned in place.

Why is it done?

Anterior cruciate ligament injuries do not heal by themselves. Arthroscopic ACL reconstruction allows for a minimally invasive procedure which can restore secure motion of the knee with a minimum amount of time needed for recovery.

Risks & complications

Although rare, complications do occur during or following arthroscopy.  They include the possibility of:

-  Accidental damage to structures inside or near to the joint

-  Excessive bleeding inside the joint which can cause swelling and pain

-  Infection within the joint

-  Reaction to the anesthesia

Risks can be reduced by following the surgeon's instructions before and after surgery.

Alternatives

The surgeon may discuss alternative approaches to the Arthroscopy procedure.  For example ‘open surgery’ may be indicated in cases where arthroscopic intervention will be ineffective.

Candidate eligibility

The best candidates for Arthroscopy are healthy adults with no previous surgeries or scarring in the area being treated. The surgeon will make the final determination of each patient’s eligibility for the procedure after an examination and consultation with the patient.