Learn about ACL Reconstruction, including the procedure, recovery timeline, and rehabilitation process. Discover how Palms Physiotherapy can assist with pre-habilitation and post-operative rehabilitation for ACL reconstruction surgery.

ACL Reconstruction: Procedure, Recovery & Rehabilitation

What is ACL Reconstruction?

ACL reconstruction is a surgical procedure to replace a torn anterior cruciate ligament (ACL), one of the major ligaments that helps stabilize the knee joint. The ACL is commonly injured during sports, particularly in activities involving sudden stops, pivots, or changes in direction. Reconstruction typically involves using a tendon from the patient's body (autograft) or from a donor (allograft) to replace the damaged ligament.

Conditions Treated with ACL Reconstruction

• ACL Tear or Rupture: The most common reason for this surgery, often caused by sports-related injuries.

• Severe Knee Instability: When the ACL tear leads to significant knee instability, preventing normal activities.

• Chronic ACL Tears: When a torn ACL hasn’t been treated and leads to ongoing pain or difficulty.

• Knee Joint Damage: If ACL injury has caused damage to the cartilage or other structures in the knee, ACL reconstruction may be needed.

The Procedure

1. Preoperative Preparation:

   • Before ACL reconstruction surgery, your doctor may order an MRI to assess the damage to the ligament and other knee structures.

   • A physical therapy program might be recommended prior to surgery to strengthen the muscles around the knee and improve range of motion.

2. During the Procedure:

   • ACL reconstruction is usually performed under general anesthesia.

   • The surgeon makes small incisions around the knee, inserts an arthroscope to visualize the joint, and removes the damaged ACL.

   • A graft (either autograft or allograft) is then inserted and secured with screws or other fixation devices to restore knee stability.

   • The surgery typically lasts 1-2 hours, depending on the complexity.

3. Postoperative Care:

   • Post-surgery, you may need to stay in the hospital for a few hours for monitoring.

   • Pain management, ice therapy, and knee bracing will be used in the immediate recovery period.

   • You will be encouraged to start light physical therapy and begin range-of-motion exercises shortly after surgery to avoid stiffness.

Healing and Recovery Time

• Initial Recovery (Week 1):

  • Swelling, bruising, and discomfort are normal. You’ll be encouraged to use crutches for the first few days to avoid putting weight on the knee.

  • Rest, ice, and elevation will be crucial during the early recovery phase.

• Early Recovery (Weeks 2-4):

  • Most patients begin physical therapy within the first 2 weeks, focusing on reducing swelling and improving knee motion.

  • You’ll gradually increase activity levels, with many patients transitioning to walking without crutches by the end of Week 2.

• Intermediate Recovery (1-3 Months):

  • By 6 weeks, you should have good knee motion and strength, though full recovery and return to more intense activities may take several more months.

  • Patients will work on regaining quadriceps strength, balance, and mobility during this phase.

• Full Recovery:

  • Full recovery typically takes 6-9 months, and return to high-impact activities, including sports, may take 9-12 months after surgery.

  • Regaining full knee function and strength is a gradual process, and the timeline can vary depending on the individual and rehabilitation efforts.

Rehabilitation After ACL Reconstruction

Rehabilitation is the most crucial part of the recovery process to ensure the success of the surgery and return to regular activities.

1. Post-Operative Rehabilitation:

   • Phase 1 (Weeks 1-2): Focus on controlling pain and swelling, performing passive range-of-motion exercises, and starting gentle quadriceps and hamstring strengthening.

   • Phase 2 (Weeks 2-6): Increase weight-bearing activities, begin active range-of-motion exercises, and work on muscle activation for strength recovery.

   • Phase 3 (Weeks 6-12): Introduction of functional exercises like squats, lunges, and controlled movements that mirror normal activities.

   • Phase 4 (Months 3-6): Strength and endurance training to restore muscle function, improve balance, and work on proprioception (joint position sense).

   • Phase 5 (Months 6-9): Advanced functional training, sport-specific drills, and agility exercises, depending on the individual’s progress and the doctor’s recommendations.

2. Progressive Strengthening and Return to Activity:

   • Rehabilitation focuses on gradual progression of activities. Return to running or intense physical activity should be approached cautiously.

   • Regular check-ins with the surgeon and physiotherapist are important to ensure that the graft is healing properly.

Frequently Asked Questions (FAQ)

1. How long is the recovery period after ACL reconstruction?

• Full recovery from ACL reconstruction usually takes 6-9 months, with the possibility of returning to sports after 9-12 months depending on individual progress.

2. Do I need physical therapy after ACL reconstruction?

• Yes, physical therapy is essential after ACL reconstruction. It helps restore range of motion, strength, and stability in the knee joint.

3. Can I walk immediately after ACL surgery?

• Most patients can start walking with crutches within 1-2 weeks after surgery, with progression to weight-bearing activities over time.

4. When can I return to sports after ACL reconstruction?

• Returning to high-impact sports typically takes 9-12 months after surgery, depending on the individual’s rehabilitation progress and the approval of the surgeon.

How Palms Physiotherapy & Allied Health Can Help

At Palms Physiotherapy & Allied Health, we specialize in pre-habilitation and post-surgical rehabilitation for ACL reconstruction. Our services include:

1. Pre-Habilitation:

   • Strengthening the muscles around the knee and improving joint mobility before surgery, which can lead to a faster and more successful recovery.

2. Post-Operative Rehabilitation:

   • A customized rehabilitation program tailored to your needs, with a focus on reducing pain, improving range of motion, and restoring strength, stability, and function to the knee.

Reputable Australian Resources

1. Australian Physiotherapy Association (APA)

   • For more information on rehabilitation after ACL reconstruction.

   • https://australian.physio/

2. Better Health Channel (Victoria)

   • Comprehensive resources on ACL reconstruction and recovery.

   • https://www.betterhealth.vic.gov.au/

3. HealthDirect Australia

   • General health information on ACL injuries and recovery.

   • https://www.healthdirect.gov.au/

4. Royal Australasian College of Surgeons (RACS)

   • Trusted surgical information on ACL reconstruction procedures.

   • https://www.surgeons.org/

For personalised care and rehabilitation after ACL Reconstruction, contact Palms Physiotherapy & Allied Health to schedule an appointment with our experienced physiotherapists.