A torn ACL, whether full or partial, is one of the most severe and painful injuries an athlete can suffer. However, now, with advances in sports medical technology, an ACL tear is no longer a career-ending injury if the athlete undergoes surgery to repair the tear. (See How to Tell if You Have an ACL Tear.)
I’m living proof of this. During a 2012 volleyball tournament, I suffered an ACL, MCL and meniscus tear. Like many knee injuries, mine occurred due to an impact from the outside of my knee. Before I went down, I heard numerous pops, then the area went numb. I was removed from the gym on a stretcher and taken to the emergency room, where I was told that I had snapped three ligaments and suffered some bone fracturing at the point of impact. The injury devastated me, mostly because of my fear of losing the rest of the season.
Without reconstructive surgery, I could heal on my own, but I would probably never be able to play competitively again. I immediately decided I wanted to get back on the court as soon as possible. Knowing the road ahead would be long and difficult, I found the most highest recommended orthopedic surgeon in my area and decided I’d abide by his every instruction.
Here is what the process looks like. (See also The Athlete’s Guide to the ACL.)
It starts with an MRI to determine the extent of the damage, then immediately progresses to physical therapy. Many people don’t know that an athlete must return to full mobility before ACL surgery—for two reasons: the better your recovery pre-surgery, the faster the healing post-op; and during surgery, the knee must be bent more than 90 degrees in order to access the correct angle and align the drill on the correct path for the new ligament.
Pre-Surgery: Day of
To give you time to complete the pre-op phase of PT, your orthopedic surgeon will set a surgery date more than a month out from the date of the injury. Once you are cleared for surgery, you’ll be brought in for a full overview of anesthesia and operation procedures. This is a very important step and should not be overlooked.
On the day of your surgery, you will need to have someone drive you home after the operation. The medical staff then slowly puts you under anesthesia and takes you into the operating room.
Once you are inside the operating room, the doctor will make three small (less than a half-inch) incisions around your knee. One is for the camera scope and two are for the surgical tools. The first job is to clean out the injured knee, meaning removing the damaged ACL, torn pieces of meniscus and any scar tissue that has formed. MCL ligaments rejuvenate like no other part of the body, so replacing the ligament is never needed in MCL surgery.
My new ACL ligament—taken from the patella tendon of a cadaver—was threaded through the original track where the torn ACL once lived. With a titanium plug on one end holding it in place, the new ACL was guided by thread into its new place and held secure by a bone plug drilled into place. Like the MCL ligament, bone has its own healing power, and it eventually dissolves the bone plug into itself. In this capacity, the bone will heal in about six to eight weeks.
Once the new ACL ligament is in place, you will be left with three small dash-type scars and one two- to three-inch scar at the point where the drilling took place.
Upon waking from surgery, you’ll feel groggy as the anesthesia wears off. Then you’ll notice the full metal leg brace, complete with side dials for future bending ability. Underneath it all, you’ll find a circulating ice machine constantly running cold water over the surgical areas. But you’ve done it: you’ve survived ACL reconstructive surgery. Your next PT appointment will be one week from the surgery, when you will begin trying to move your leg. In the meantime, stay put, ice as often as possible, and don’t touch or change the bandages yourself (a follow-up post-op appointment with your surgeon will take care of that).
Before my surgery I bought a shower chair. This is essential, because at first you cannot stand for longer than a few seconds, and certainly not in a wet, slippery area. Remember to rest, and have help at all times.
In a week, you will begin your physical therapy phase. It is hard, difficult and frustrating. But keep in mind: it takes a full six months from the day of the surgery to get back at your competitive sports-loving self again; so take it slow, stay focused and don’t forget your physical therapy homework. (Read How to Return to the Field After an ACL Injury.)