The anterior cruciate ligament (ACL) is a ligament that runs diagonally in the middle of the knee, providing rotational stability. ACL tears are one of the most common knee injuries, particularly among athletes and more active individuals. When the ACL is torn, patients often need surgical reconstruction with a tendon graft to regain the strength and stability needed to return to more active lifestyles.
Dr. Wathne is fellowship trained in sports medicine, and has treated many ACL injuries over the 25 years he has been in practice. He is skilled in all ACL reconstruction approaches and selecting the best tendon graft option that best fits the patient’s needs. Dr. Wathne frequently performs revision ACL reconstruction on patients who have had failed procedures with other surgeons. He also works with many of the local high schools to provide sports medicine coverage.
Symptoms of an ACL Tear
ACL tears tend to be more common among female athletes, possibly because of their different anatomy and techniques when compared to male athletes. If your ACL is torn, symptoms typically appear right after the injury occurs. If you experience any of the following symptoms, you should seek an evaluation with an experienced sports medicine specialist like Dr. Wathne to receive a proper diagnosis and treatment plan.
Common symptoms of an ACL tear include:
- Immediate pain that may be accompanied by a “popping” sensation
- Feeling the knee “give out” from under you
- Swelling of the knee within 24 hours of the injury
- Inability to move the knee through its full range of motion
- Tenderness at the joint
- Pain or discomfort while walking on the knee
A physical examination and imaging tests can confirm whether or not the ACL is torn. If the ACL is torn, it will not heal without surgery. Dr. Wathne will discuss options with the patient to determine the best course of action for ACL reconstruction.
ACL Reconstruction Procedure
An ACL reconstruction procedure involves using a tendon graft to rebuild, or reconstruct, the torn ligament. Typically, a torn ACL cannot be simply stitched back together. A tendon graft supplies a structure for the new ligament to build upon, which leads to a stronger ligament and better long-term results.
Tendon Graft Selection
Tendon grafts can be taken from several different sources. In many cases, Dr. Wathne will take a graft from the patient’s own tendon, though a cadaver graft can be used if needed. Grafts can be taken from the patellar tendon, the hamstring tendon, or the quadriceps tendon. Dr. Wathne will learn more about the patient’s needs and lifestyle to select the graft that best fits their needs.
Graft selection is an important component to the success of your surgery. Some surgeons exclusively use one type of graft, but Dr. Wathne is experienced in using all graft types and feels it is important to choose the graft the best fits the patient’s needs.
Arthroscopic ACL Repair
Dr. Wathne typically completes ACL repairs with arthroscopic surgery. During an arthroscopic ACL repair, Dr. Wathne inserts a small camera called an arthroscope into a small incision in the knee. The camera displays images on a monitor, allowing him to view the structures of the knee without having to make a large incision. He can then insert surgical instruments through additional small incisions to position the tendon graft apply fixation devices like screws and staples to hold the graft in place.
Recovering from ACL Reconstruction
Most patients are able to return home the day of surgery. Dr. Wathne’s team injects the knee with a long-acting pain medication prior to surgery, which helps alleviate pain in the immediate recovery period. Patients are also given medications to help with pain after the effects of the injection wear off.
Though arthroscopic surgery helps to reduce pain after surgery as compared to an open procedure, recovering from ACL reconstruction is a multi-staged process. Dr. Wathne cautions patients not to try to take on too much too soon, as this can affect the long-term success of the procedure. Patients start off wearing a knee brace, then graduate to crutches, and then begin working on range of motion. If the patient’s insurance authorizes it, the patient may also use a continuous passive motion (CPM) machine in the early recovery period to help gently flex and extend the knee. This can help improve range of motion early on.
Patients usually participate in physical therapy for at least 6-12 weeks, though athletes may need to work at it longer to regain the level of strength needed to return to sports. Though patients may work with any physical therapist they’d like, physical therapy is offered on-site, which makes the process more convenient for patients. This also allows Dr. Wathne to work closely with the physical therapy team to determine when patients are ready to resume activities.
For athletes, it can take an average of 9-12 months to be able to return to sports. Though that can be disappointing for an athlete to hear, Dr. Wathne does this for the patient’s safety. It is important that patients take their time to properly heal from ACL surgery before putting the ligament under a great amount of stress. When athletes return to sports too soon, they have a higher risk of having a failed procedure. With ACL reconstruction, Dr. Wathne considers the long-term results, which the patient benefits from the most.
ACL Reconstruction in Pocatello, ID
Dr. Richard Wathne is a board certified orthopaedic surgeon and sports medicine specialist with 25 years of experience. He works with many of the local high schools to provide medical coverage for sports injuries, including ACL tears. If you would like to learn more about ACL reconstruction surgery, or schedule an appointment with Dr. Wathne, please call our office at (208) 233-2100 or request an appointment via our online form.