Anterior Cruciate Ligament/ Posterior Cruciate Ligament Reconstruction

Understanding ACL and PCL Injuries

Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL) are important knee ligaments that maintain stability as well as aid movement. Injuries to ligaments tend to arise from rapid twists, blows, or high-risk sporting activities involving football, basketball, and skiing. ACL damage tends to prevail more in sporting personalities, while PCL injuries most commonly stem from direct traumas like a motor vehicle crash or a fall.

During an ACL injury, people might feel the knee "pop" when it happens. Later, the knee will start swelling. This instability causes a painful limp when walking shortly after the injury.

If not treated on time, one will start noticing weakness and loss of confidence in the affected knee relative to the unaffected one. Returning to sporting activities that usually involve twisting becomes impossible. While there may not be immediate pain with an unattended long-standing ACL injury, associated structural problems or prolonged neglect can cause immense pain. Overlooking an ACL injury until pain arises is not at all advisable by healthcare experts.

PCL injury typically happens when a bent knee is stuck with the foot in a flexed position but it can also happen with hyperextension of the knee. Such injuries most often happen in motor vehicle crashes and sports. 

For professional diagnosis, state-of-the-art treatment facilities, and total rehabilitation for PCL and ACL injuries, Marengo Asia Hospitals offers the world's best orthopaedic services with experienced specialists committed to ensuring flawless recovery.

Conditions/Issues That Require ACL/PCL Reconstruction

• Surgical reconstruction of the ACL or PCL is advised when:
• The ligament is torn fully and the knee is unstable and buckles during activity.
• Conservative management, like physiotherapy, fails to correct knee function.
• There is severe pain or inability to carry out everyday activities.
• There are multiple ligaments involved or meniscus is damaged.

Diagnostic Tests for ACL & PCL Injuries

Prior to surgery, doctors conduct a series of tests to determine the extent of the injury. These tests are used to ascertain if the ligament is ruptured, the degree of damage, and if other structures within the knee are involved.

• Physical Examination is conducted to check for knee stability, swelling, range of motion, and tenderness. By comparing the injured knee with the healthy knee, healthcare providers are able to identify abnormal movements that are an indicator of ligament damage.
• MRI Scan is the best imaging method to evaluate ACL and PCL injuries. It produces good images of soft tissues, and it depicts tears of the ligaments, edema, and any related injuries to meniscus or cartilage.
• X-ray is used to rule out fractures and bone injuries. Although it will not demonstrate a tear in ligaments, it can reveal avulsion or displacement of bone associated with a tear in the ligament.

What Happens During ACL/PCL Reconstruction?

Reconstruction of the Posterior Cruciate Ligament (PCL) and Anterior Cruciate Ligament (ACL) is a surgical procedure for restoring knee function and stability. The procedures are usually advised in case the ligament is totally torn and can't heal naturally.

ACL/PCL Reconstruction Procedure

1. Graft Selection is the initial process of ACL/PCL reconstruction. As the torn ligament can't be sewn back, a graft is employed to substitute it. The graft is most often harvested from the patient's own body (autograft) or from a donor (allograft). Sources commonly used are the patellar tendon (which attaches the kneecap to the shinbone), the hamstring tendon, or the quadriceps tendon. Each graft has its benefits, and the selection is based on such factors as patient activity level and surgeon preference.
2. Arthroscopic Surgery is performed using minimally invasive techniques. Tiny cuts are made on the knee, and an arthroscope (a tiny camera) is inserted in to get a proper view of the joint. This allows the surgeon to examine the tissues of the knee and perform the reconstruction with great accuracy without traumatizing adjacent tissues and with faster recovery.
3. Graft Placement involves removing the damaged ACL/PCL and replacing it with the selected graft. The femur (thigh bone) and tibia (shin bone) are drilled to create tunnels in which the new graft is attached. Screws, buttons, or fixation devices hold the graft in place so that it can function like the original ligament. The body incorporates the graft over time, transforming it into a functional ligament.
4. Closure and Recovery is the final stage of the procedure. The incisions are closed by sutures and a clean dressing is applied. The rehabilitation starts immediately on the same day to prevent stiffness and atrophy of muscles. The initial priority is swelling reduction and restoration of motion range, followed by strengthening exercises. The rehabilitation places the majority of the patients back to sports between 6 and 8 months depending on how fast they recover.

Benefits of ACL & PCL Reconstruction

• Restores function and stability of the knee.
• Enables patients to resume daily activities and sports.
• Prevents long-term damage to the joint or osteoarthritis.

How Marengo Asia Hospitals Can Help

Our specialist orthopaedic surgeons at Marengo Asia Hospitals use the newest techniques and facilities to ensure successful ACL and PCL reconstructions. Our intensive rehabilitation programs help patients recover their strength, mobility, and confidence in knee function, allowing them to return to an active life safely.

With our team of expert orthopaedic surgeons and physiotherapists, you can rest assured of:

• Expert Diagnosis & Treatment Plans carefully designed to individual patient requirements.
• Minimally Invasive Surgery for faster healing and less postoperative pain.
• State-of-the-Art Rehabilitation Programs for immediate return to mobility.
• Personalized Post-Surgery Care to enable maximum healing and long-term health of the knee.