Rebuilding Worn Knees

Damage to the ACL (anterior cruciate ligament), the most common injury, occurs in athletes who play basketball, football, tennis or soccer, or in skiers. An MRI helps reveal the extent of the damage.

Ligament Reconstruction for a Return to Normal

Knee reconstruction– either total or partial– is actually a tissue graft. The orthopedic surgeon takes healthy tendon tissue from the patient’s own hamstring muscle or knee, and uses it to replace a damaged ligament. In some cases, donor tissue may be used.

knee ligaments injuryThere are four ligaments that support the knee, allowing for weight-bearing strength and flexibility.

  • The posterior cruciate ligament (PCL) and anterior cruciate ligament (ACL) are located inside the knee joint. They control our back-and-forth movement.
  • The medial collateral ligament (MLC) is on the side of the knee towards the body;
  • the lateral collateral ligament (LCL) is on the outside of the knee. The collateral ligaments control sideways motion. They are the ‘brakes’ that protect us from harmful movements.

Ligaments connect one bone to another. The ACL connects the femur (thigh bone) with the tibia (shin bone). A torn ACL is the most common knee injury.

This ligament was designed to handle forward motion and rotation of the tibia.
ACL injuries are most common in athletes between the ages of 15 and 45– the ages when people are most active.

knee ligament recontructionOther Knee Ligament Injuries

We also see injuries to the PCL, the ligament that controls backward movement of the tibia; the MCL, which supports the inner part of the knee; and the LCL, which stabilizes the outer knee.

ACL injuries are often caused by a specific event. The patient is usually in pain, and has limited function or mobility. He or she may want to return to their sports or favorite activity as soon as possible.

Knee Ligament Reconstruction Recovery

Generally speaking, recovery time for knee constructive surgery falls into phases. The first one to three weeks are focused on decreasing the swelling by elevating and icing the leg, and exercises on a stationary bicycle.

  • From two to six weeks post-surgery, the patient is given exercises to improve range of motion and strength.
  • From six weeks to about four months, the patient can begin jogging. After six months, the patient may return to sports activities.

Surgical techniques for repairing damaged knees have made great advances over the past few decades, and many elite athletes recover and go on to excel after suffering an injury that, a few decades ago, would have ended their career.

To find out more about knee ligament reconstruction read through the National Institutes of Health (NIH) website or contact our Pembroke Pines Orthopedics clinic to speak with one of our Miami orthopedic surgeons or to schedule an appointment.

Before Knee Ligament Reconstruction Procedure
You will meet with your orthopedic surgeon for an initial consultation to over your symptoms, medical history and give the doctor the opportunity to diagnose your symptoms with a physical examination and potentially a knee arthroscopy.

Your local Pembroke Pines orthopedic surgeon will take the time to explain the procedure and answer any questions or concerns you may have regarding the procedure.

As with any medical procedure, your doctor will require you to sign a consent form to allow them the ability to treat your ligament tear. Be sure to read through the papers to make sure you understand the extent of the consent form before your treatment so you can ask any questions you may have.

  • If it is not covered in your paperwork, be sure to inform the doctor of any allergies you may have to any medical materials or medications.
  • Your doctor will want to know if you are actively taking any medications.
  • Inform you surgeon of any medications or conditions that affect blood flow throughout the body as they could lead to potential complications. Your doctor may ask you to stop taking these medications a few days before the procedure.
  • Always avoid any complications if you are pregnant or suspect that you may be pregnant.
  • To avoid potential risks during the procedure, you will be asked to abstain from any food or water after midnight of the night before the procedure.
  • If you have been prescribed a relaxing sedative for the night before the procedure, you will need to make arrangements for getting to and from the clinic as these sedatives can make patients drowsy and unsafe to operate a vehicle.
  • It is not uncommon to meet with a physical therapist to make arrangement for rehabilitation before the procedure.
  • Be sure that you are not overexerting yourself after the procedure by making arrangements to have help with getting around and managing your house the week following your procedure.
During the procedure
Your procedure will ultimately depend upon your precise condition and the general practices of your orthopedic surgeon.

Patients are most commonly given a general anesthetic for knee ligament reconstruction to avoid pain or discomfort. Discuss with your surgeon which option of procedural pain management you are able or willing to take.

This is how the standard knee ligament reconstruction process will look:

  • You will change from your street clothes into a gown for the procedure.
  • An IV will be inserted to maintain hydration throughout the procedure.
  • You will take your proper place on the operating table.
  • The anesthesiologist will prepare you for the operation by monitoring your vitals.
  • The site will be prepared for the operation with an antiseptic.
  • Your surgeon will start the process of incisions into the knee.
  • Using knee arthroscopy to see inside the knee, the doctor will begin treating the damaged knee ligament. If the ligament can be reattached, the doctor will proceed to do so. For tears that cannot be reconnected, the ligament will required to be reconstructed with grafts of ligament from either a donor, or another part of the patient’s body.
  • By threading the grafts through tiny holes that the surgeon has drilled in the femur and tibia, the doctor can effectively recreate a healthy ligament. With the help of a series of surgical screws or staples, the graft is secured in place.
  • The doctor will then proceed to stitch or staple the initial incisions and bandage the site of the incisions.
After Knee Ligament Reconstruction
Immediately following your procedure, doctors will be waiting for the anesthesia to wear off before guiding you and your friend or family member accompanying you home through the recovery process. In the meantime, the doctors will be checking your vitals once more to ensure that nothing went wrong during the procedure.

The clinic will likely supply you with some form of support or knee immobilizer to assist in a safe recovery from your injury and the procedure.

Monitoring the operation site is important. Be sure to follow the instructions for cleaning and maintaining your incisions closely and keep them clean and dry at all times.

At first, ice and elevation is recommended to help reduce the swelling in the area. Once the swelling has subsided, you will begin your physical rehabilitation process.

Monitor your pain through medication as instructed by your surgeon. Be certain to call your doctor if you are experiencing any of these symptoms or extreme pain that does not fade with the help of the medication:

  • Persistent or abnormal drainage at the site of the incision
  • Elevated temperature (fever)
  • Excessive and persistent pain at the site of the incision

Talk with your doctor closely about your timeline of recovery. You won’t likely be able to return to your normal routine for some time after your procedure.