ACL reconstruction and ACL repair both are the same. The anterior cruciate ligament (ACL) is one of the 4 knee ligaments that connect the femur to the tibia and holds the bones of the knee together. it's the band of tissues within the knee that helps keep the knee stable. ACL is one among the commonly injured ligaments of the knee and most ordinarily occurs in players of high-risk sports, like football, basketball, soccer, and skiing. Very rarely the sole ACL is injured as any injury to the knee causes damage to other structures too.
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What can cause an injury to the ACL?
An injury to the ACL occurs when it stretches an excessive amount of or tears apart thanks to overstretching. this will occur within the following conditions:
Turning sharply or moving suddenly while running or jumping
Stopping suddenly then changing direction
Jumping and landing
Symptoms of ACL injury
Many people hear a “pop” like voice when ACL gets injured. Also, in most of the cases, an injury to the ACL is usually related to injury to other knee structures and therefore the symptoms revolve around the knee including:
Difficulty putting pressure on the knee
Pain while walking
Rapid swelling over the knee
Loss of range of motion of the knee
Knee stiffness and instability
‘Giving away’ of the knee
What all examinations are done to diagnose ACL injury?
ACL injury requires thorough examination and diagnostics for its evaluation. the method of diagnosis involves the following:
Clinical exam: First and foremost, the doctor takes the patient history and notes down his prime complaints. He also will ask the patient for any recent history of injury or fall during sports activity or sudden twisting of the knee. After knowing these details, the doctor performs a physical examination of the patient and can feel his knee (palpate) for any tenderness and heat. He also will move the knee and leg into different positions and watch the patient walk to seek out out the injury.
X-ray: In most cases, an X-ray of the knee is completed to work out the presence of any fractures and therefore the extent of the damage.
MRI scan: MRI can also be required in some cases to gauge the extent of the ACL tear and determine if there's any concurrent damage to the opposite ligaments and cartilage of the knee.
Exploratory arthroscopy: In very rare cases, exploratory arthroscopy is completed to ascertain the within of the knee also as ACL and other ligaments to work out what quite a treatment is going to be appropriate for the patient.
Treatment
In most of the cases of a minor ACL tear, non-surgical methods of treatment like RICE (rest, ice, gentle compression, and elevation), joint immobilization, or physiotherapy give relief to the patient. Recovery and rehabilitation of the ACL injury usually take a minimum of 3 months.
In cases of complete ACL rupture or tear that's also related to other joint injuries, surgery is indicated to repair or reconstruct the ACL and treat the adjoining structures for complete joint relief. So, collaborated surgery is completed to repair all the defects. Also, sewing of ACL doe doesn't allow proper healing of the ligament, so its repair is usually done employing a graft from another a part of the body like the tendon of the kneecap (patellar tendon) or the hamstring tendons.
Indications for surgery in ACL rupture
Not all patients with ACL rupture are candidates for surgical repair. So careful evaluation of the case is required before deciding for ACL reconstruction surgery. The following are the indications for ACL repair surgery:
Active adult patients who are often involved in sports that need immediate turning or twisting of the knee
Adults with jobs that need heavy manual work
ACL repair surgery in children should be delayed until skeletal maturity
Patient with significant functional instability of the knee
Patients with combined damage to the knee menisci, collateral ligaments, articular cartilage, etc.
The procedure
The surgery to repair or reconstruct a torn ACL is often done as “open” surgery during which an outsized incision is given within the knee or as an “arthroscopic” surgery which may be a less-invasive option and is completed through various smaller incisions. Nowadays in most of the cases, the arthroscopic procedure opts for ACL repair.
The arthroscopic ACL repair is often done under general or local anesthesia, but general anesthesia is preferred to make sure the right relaxing of the muscles surrounding the joint to conduct the procedure. It requires 4 small incisions within the knee to insert the arthroscope and other small instruments within the knee for the surgery. In one of the ways, the surgeon uses hamstring grafts to repair the torn ACL. But if the reconstruction of multiple ligaments is required then different graft materials could also be used. Specially designed screws are used for immediate fixation of the graft into the knee.
Advantages of Arthroscopic ACL repair
The procedure is quick and takes but an hour
Arthroscopic procedures are mostly done as daycare procedures and night stay isn't required within the hospital
People with desk jobs can return to figure as early as 1-2 days
There is negligible blood loss with arthroscopic procedures
The incisions are very small and conceal in joint skin layers
There are fewer risks than open surgery
Post Procedure Care
The patient is kept within the post-operative hospital room for a couple of hours to watch any signs of discomfort within the knee.
The joint is heavily padded and pain relief medications and antibiotics to stop infection are started soon after surgery.
In most cases, ambulation is started on an equivalent day. Some patients may require crutches for the primary few days.
A gradual increase in walking distance is suggested to the patient
Regular movement of the knee should be administered even while sitting or lying down through a special range of motion as tolerated.
The operated knee should be kept elevated above the extent of the heart with two pillows under the whole leg for the primary few days after surgery.
Apply an ice pack to the knee to stop swelling and pain.
The patient should do thigh muscle tightening exercises for the primary few weeks after surgery.
Physical therapy, if required, could also be started 3-5 days after surgery Results of ACL Repair
Most of the patients can bear weight on the operated knee and walk comfortably soon after the surgery. Driving and other minor activities are often started the day after the surgery. Patients with a sitting job can resume work as early as 1-2 days, while heavy manual employment may require 6 weeks. It's going to take almost 6 weeks to start out running during a line. Slowly other activities are introduced, and therefore the patient can revisit to a usual lifestyle within 6 months after the surgery.
ACL Reconstruction Cost in India
Find ACL Reconstruction with the latest technology in the best hospitals in India. The average cost for the best ACL Reconstruction in India ranges between USD 4000 to USD 6000 depending upon the hospital and facilities. The estimated days in the hospital are 5 days and 12 days outside the hospital.
Best Orthopedic Hospitals in India
Indraprastha Apollo Hospital, Delhi
Hosmat Hospital, Bangalore
Apollo Hospitals, Greams Road, Chennai
Max Super Specialty Hospital, Saket, Delhi
Apollo Hospital, Jayanagar, Bangalore
Moolchand Medcity, Delhi
Nanavati Hospital, Mumbai
SL Raheja Hospital, Mumbai
Artemis Hospital, Gurgaon
Columbia Asia, Pune
Fortis Memorial Research Institute, Gurgaon
Sahyadri Hospitals, Pune
Manipal Hospital, HAL Road, Bangalore
Fortis Hospital, Kolkata
MaxCure Hospitals, Hyderabad
Orthopedic Doctors in India
Dr. Sunil Apsingi - Knee & Shoulder Specialist
Dr. V. Surya Prakash Rao - Consultant Orthopedic & Spine Surgeon
Dr. K.R. Anil Kumar Reddy - Consultant Orthopedic & Joint Replacement Surgeon
Dr. K.L. Himakanth - Consultant Orthopedic Surgeon
Dr. Anindansu Basu - Consultant Orthopedic & Joint Replacement
Dr. Ashwin Chowdhary - Consultant Orthopedic & Joint Replacement
Dr. Avishek Ray Ghatak - Attending Consultant Orthopedic & Joint Replacement
Dr. Gaurav Gupta - Consultant Orthopedic & Joint Replacement
Dr. Hemant K. Kalyan: Consultant (Orthopedics)
Dr. K. M. K. Varma: Consultant (Orthopedics)
Dr. Manoj Kumar A. N: Consultant (Orthopedics)
Dr. Prashanth Inna: Consultant (Orthopedics)
Dr. Arun Pai - Orthopedic & Joint Replacement Surgeon
Dr. Chetan Oswal - Orthopedic & Joint Replacement Surgeon
Dr. Nilesh Jagtap - Orthopedic & Joint Replacement Surgeon
Dr. S.Y. Kulkarni - Orthopedic & Joint Replacement Surgeon
Dr. Sanjay Kulkarni - Orthopedic & Joint Replacement Surgeon
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