Private anterior cruciate ligament (ACL) surgery in East London
ACL injuries are amongst the most common knee injuries. They typically occur during sports that require sudden stopping and starting and pivoting movements.
Not everyone who has injured their ACL needs surgery, but if you would like to return to the same level of physical activity or your knee is extremely unstable and has sustained further injury, ACL surgery is typically recommended.
This article will explore who might need ACL surgery, how it is performed, considerations for surgery success and recovery times at The London Independent Hospital.
Ligaments are strong bands of tissue that connect bones to bones. Four major ligaments of the knee support the knee’s stability: two cruciate ligaments and two collateral ligaments.
The collateral ligaments on the sides of the knee control the sideways motion of your knee. The cruciate ligaments are located inside the knee and control your knee’s back and forth motion. The anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) cross each other to form an ‘x’ inside your knee joint.
Your ACL runs diagonally in the middle of the knee to connect the upper part of the tibia (shin bone) with the lower part of the femur (thigh bone). Along with the PCL, the ACL provides stability to the knee joint.
Approximately half of all ACL injuries occur in combination with damage to the meniscus. The menisci are two C-shaped pieces of cartilage that cushion the femur and tibia bones of the knee during weight-bearing activities.
According to Mr Tarun Taneja, Consultant Orthopaedic & Knee Specialist Surgeon at the London Independent Hospital, “Each patient’s treatment has to be individualised depending on factors like their age, activity levels, sporting activities and what their expectations are in terms of their activity levels after their recovery.”
He continues, “It’s also dictated to an extent by their associated injuries. If somebody has a significant meniscal injury in addition to an ACL tear and is a young, active person, that almost pushes us more towards the surgical option.”
Your consultant is likely to recommend ACL reconstructive surgery if you are an active adult and any of the following applies to you:
Surgery is usually the best choice for young, active patients to stabilise their knee and ensure their return to sports and other activities.
Older and more sedentary individuals might decide against ACL reconstructive surgery in favour of conservative therapy. This includes physiotherapy, modifying your activities and using knee braces. You should be prepared to give up high-risk sports that involve cutting and pivoting for activities such as swimming, cycling or yoga.
After your consultant has discussed your personalised treatment plan for your ACL reconstruction with you, you will need to wait a few weeks for the swelling to go down and to ensure your knee's full range of movement.
Before surgery, it is a good idea to do physiotherapy to strengthen your muscles, particularly your quadriceps.
Rehabilitation before surgery — ‘Prehab’, or prehabilitation — is an integral part of the process.
Ensuring that your knee has its full range of motion and that your muscles are as fit and healthy as they can be before your surgery helps you recover faster after your ACL surgery.
When your consultant says you are ready for surgery, you can book your appointment for your operation. One benefit of private care at The London Independent Hospital is the ability to book your surgery at a time that suits you.
Your consultant will let you know what specific preparations you need to do for the surgery. This could include instructions and information about:
The surgery takes between 1–2 hours, and you will be under general anaesthesia, so you will be unconscious, and you will not feel any pain during the procedure.
ACL surgery can be done in various ways, but the most effective method is reconstructing your ACL ligament with a piece of your tendon, a band of tissue that connects your muscle to a bone. This tendon is called a graft and functions as the new ACL.
A graft taken from your own body is called an autograft. A graft taken from a donor (someone who has given permission for their organs to be donated after their death) is called an allograft.
Autografts can be sourced from various places:
Your surgeon will discuss details of the surgery, graft options and post-surgery rehabilitation.
The procedure is performed using a technique called knee arthroscopy, which is more commonly known as keyhole surgery.
This means that your orthopaedic surgeon will make small cuts in your knee and pass an arthroscope (a thin, metal tube with a light and camera at the end) into your joint. Your surgeon will use the attached monitor to clearly see inside your joint and determine the extent of your injury and if any other repair work to other ligaments, such as repairing the meniscus, needs to be done.
After harvesting the graft, the surgeon will drill two bone tunnels — one in your tibia and another in your femur, and thread the graft through. Your surgeon will then fix the tendon into place with screws and/or metal buttons, which will remain in your knee permanently.
Your surgeon will also repair any other structures of the knee, such as ligaments or meniscus tears, before closing your incisions with stitches. You will be given pain relief and a local anaesthetic to alleviate pain upon waking.
Once conscious, you will start physio the same day before being discharged to go home.
After six weeks, you will have a post-operative appointment with your consultant to check that your wound is healing properly and assess your full range of movement and muscle strength.
You’ll have additional check-ups with your consultant following the initial appointment.
Your recovery timeline after surgery will depend on your individual situation. The healing process takes about nine months to get back to your pre-injury activities.
After your surgery, physiotherapy will be essential to help you reach your individual rehabilitation goals.
With guidance and personalised exercises from your physiotherapist, you might expect to have a recovery that roughly follows the following timeline:
ACL reconstructive surgery is major surgery with a lengthy recovery process. But with the right specialist knee surgeon, you can expect good outcomes for returning to your pre-injury activity levels.
“ACL surgery, when properly performed by an experienced knee surgeon, is a very successful surgery,” says Mr Taneja. “Most people will be able to get back to their pre-injury levels of activity. If you’re treated by a knee surgeon who has experience in dealing with both ACL injuries and meniscal repairs, most people will be happy with the outcome.”
“The post-operative rehab after ACL surgery is crucial. There are about nine months of physiotherapy, and that’s almost as important as the surgery itself. So I always stress to my patients that if you cannot commit to the post-operative rehab, then you don’t need to have the surgery now. We can schedule it for a time when you think you’d be able to devote time to these nine months of rehab.”
In addition to physiotherapy, there are several things that patients can do to ensure their best outcome of success after their ACL surgery:
It’s important to follow your consultant’s instructions for returning to sport. ACL ligaments take time to grow, and if you return to sport too soon against your consultant’s recommendations, you can risk re-rupturing your graft.
With a skilled orthopaedic surgeon and your dedication to post-operative rehabilitation, you can expect good results from your ACL reconstruction. However, it’s essential that you choose the right hospital and the right surgeon to ensure your best chance of success.
“You need to go to a surgeon who is available for you at every step of the way in those nine months. You want to choose a surgeon you can depend on throughout that year and beyond if you face any problems even after a year. You also need a surgeon who will be able to liaise with physiotherapists,” said Mr Taneja.
“I think it is important for patients to choose a surgeon who is working in multidisciplinary teams with nurses and physiotherapists like we do at The London Independent Hospital because those teams can provide a higher quality of care.”
The London Independent Hospital in East London offers private ACL injury treatment and ACL reconstructive surgery performed by specialist knee orthopaedic surgeons. As part of the Circle Health Group, it also provides access to the latest technology and equipment.
When you choose The London Independent Hospital for your ACL surgery, you will be assured of the following benefits:
Our transparent fixed-price packages for ACL reconstruction are given to you in writing, so there are no hidden costs or surprises. We also offer flexible payment options for our self-pay patients.
Book an appointment online today or call us at 020 7780 2400.
Reception: 020 7780 2400
Mon-Sat: 8am-8pm
No on-site parking. Paid street parking available.
