The anterior cruciate ligament (ACL) is a band of thick tissues partly responsible for controlling the back and forth movements of the knee. If the ACL is damaged or torn, the knee often becomes unstable until it heals. When conservative treatments fail to promote healing or the tear is severe, surgery may be necessary to correct the damaged ligament. An increasingly common solution for restoring pain-free movement of the knee is arthroscopic ACL repair, a minimally invasive surgery with a high success rate.
When to Consider Arthroscopic ACL Repair
ACL damage may be repaired surgically. It's an option typically considered when the ligament and an attached piece of bone has separated from the remainder of the bone (an avulsion fracture). Repair involves the reattachment of the fragment to the rest of the bone. If the ACL isn't detached, non-surgical remedies for knee pain are usually attempted first. Arthroscopic ACL repair may also be recommended if:
• There is chronic instability in the affected knee
• The affected knee continues to give way or daily movements are difficult
• Other parts of the knee will likely become damaged from the instability
• Patients want to return to more demanding physical activities like competitive running or contact sports
How Arthroscopic ACL Repair Is Performed
Often the preferred procedure for ACL knee surgery, arthroscopic ACL repair is a minimally invasive type of surgery. Sometimes referred to as "keyhole surgery," it's performed with a special camera and surgical instruments through small incisions in the knee. The ligament is reattached to the accompanying bone while the surgeon views the joint on a monitor. A diagnostic arthroscopy may be performed before actual repair surgery to determine the extent of the damage to the knee. If the damage is severe, ACL reconstruction may be recommended.
Benefits of Arthroscopic ACL Repair
Since there is no need to fully open the joint with arthroscopic ACL repair, there is less trauma to nearby muscles. It's also easier for the surgeon to get a better view of the interior structure of the knee. The procedure is typically an outpatient procedure; and patients often benefit from fewer complication risks and a faster healing time from the surgery.
Recovery from Arthroscopic ACL Repair
The amount of time it takes to fully recover from arthroscopic ACL repair will vary. It can take anywhere from several months to a year to return to all post-surgery activities, especially for athletes looking to get back to their pre-surgery performance level. Since the procedure is minimally invasive, weight can usually be safely placed on the knee within one to two weeks. Bracing is often recommended to provide added stability and physical therapy begins soon after the affected knee can comfortably support weight.
Arthroscopic ACL repair is rarely the first treatment option unless the damage to the knee is serious enough to warrant surgical intervention. Some patients do better with an intensive rehab program while others have a lifestyle that's especially demanding on their knees and prefer surgery.