Knee Reconstruction

Initial Arthroscopy

• After a diagnosis has been made, the patient will have to undergo an arthroscopy. An arthroscopy provides 100% guarantee of the type of injury that you have sustained in your knee.
• An arthroscopy is considered a day only procedure, requiring hospitalisation of between 4 - 6 hours.
• With the arthroscopy, we use an arthroscope and instruments to ascertain the injury you have had within your knee. We also can treat other injuries such as a torn meniscus. Then, you come back to the rooms in a week's time, and we can talk to you about future surgical treatment.

Reconstruction

• The ACL or knee reconstruction itself is done by minimal invasive (arthroscopy) technique. It requires 2 puncture holes and a small incision.
• The small incisions are made to remove a a piece of tendon from your hamstring to use as a graft in the reconstruction.
• The graft is inserted into the dual hole and fixed in place with screws. There will be a screw in your femur or thighbone and a screw in your tibia or shinbone.
• This technique provides the stability and future motion for your knee closest to that of an uninjured ACL.
• Your incisions are closed with sutures, which need to be removed 10 days after surgery.

Possible Complications

As with other operations, reconstruction involves a small risk of infection and blood vessel and nerve injury. More common complications include pain in the front of the knee, loss of motion, swelling and persistent increased motion in the knee.

• Pain in the front of the knee can be controlled by modification of the physiotherapy program.
• Loss of motion is most common in patients with limited movement prior to surgery. This movement loss can also be associated with the formation of scar tissue around the graft. This scar tissue may later require treatment, as it may lead to some residual loss of movement.
• Intermitted pain and swelling can occur with a successful reconstruction. This often can be related to the amount of meniscal or cartilage damage that was present at the time of surgery.
• In the absence of any complications, a small percentage of patients will have persistent detectable increased amount of motion in their knee (or a loose graft). This can be related to a stretched graft or reinjury.

The complication rate for arthroscopic surgery has been found to be between 1.5 and 2%.

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