ACL RECONSTRUCTION
Results of ACL reconstruction operation
There is a 95% likelihood that the surgery will be successful and that you will be able to participate in the sporting activity of your choice.
We continuously strive to improve our results by careful study of the latest literature and use evidence based principals to guide us
As with any surgical procedure there is a small possibility of complications. This is a list of the most important complications:
- Infection: There is always a small risk of infection as with any operation. Infection rates vary from centre to centre. A recent study reported a 1.8% risk of infection of the knee joint after ACL reconstruction (Knee Surg Sports Traumatology Arthrosc 2013 Dec;21(12):2844). I have experienced one infection in the past 100 ACL reconstructions I have performed. This equates to a 1% risk of infection in my hands which compares favorably with the literature. Should an infection develop it can usually be treated by arthroscopic drainage of the knee with retention of the ACL graft and a course of antibiotics. Unfortunately this is not always successful and in such a case the graft will need to be removed. A revision operation where a new ACL reconstruction is performed can be performed at a later stage.
- Loss of movement (stiffness of the knee): There is a remote possibility of not fully regaining maximum range of motion. One of the more common causes for loss of full extension (straightening) of the knee is a so-called Cyclops lesion. This is a nodule of scar tissue that forms in front of the ACL graft in up to 10% of cases. It can cause a painful loss of full extension of the knee in a small number of these cases. If this does occur it can be treated with a repeat arthroscopy to remove the Cyclops lesion.
- Reactive effusion (swelling of the knee): This occurs occasionally and typically at around the 6 week period post surgery when the activity and rehabilitation exercises increase. If this occurs it is helpful to aspirate (draw off) the fluid from the knee.
- Failure of ACL reconstruction: A large recent study reported an overall incidence of 6.2% risk of rerupture of the ACL following ACL reconstruction (Arthroscopy 2013;29(9):1566). The ACL can be reconstructed once again, but the results of revision operation are not as good as the primary ACL reconstruction. It is important to understand that if your native ACL has ruptured it is not realistic to think that a reconstructed ACL is indestructible. I have a great deal of experience in performing revision ACL reconstruction operations for people who have had a rerupture or clinical failure of a previous ACL reconstruction.
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