Know Your Knee Better And The Ligaments That Make You Walk

Anterior Cruciate Ligament

“I was playing tennis, and I felt something being plucked in my knee…”

Neal is thirty-one years old when he injured his knee while playing tennis. This is the story of his experience with an ACL surgery and getting back to feeling healthy and to his passion again.

Let’s read what Neal went through in his words…

When I had my first serious knee injury at the age of thirty-one, I suddenly realized how much we all take for granted about the way our bodies work. When you’re young, active and in good shape, you tend to believe that nothing serious can ever happen to you. Well, it finally happened to me. I felt as if something was cut inside my left knee, but I ignored it. Initially, it didn’t seem as if something serious had happened. Everything felt all right after I just did a deep knee stretch.

Little did I know the ACL (Anterior Cruciate Ligament) in my left knee was torn. About a month later, I was playing again and slipped again, and for a  minute, everything was fine; but immediately in a moment it felt like someone just deactivated my whole leg. It had hardly hurt last time, but this time the pain was unbearable. The pain forced me to admit that there was something seriously wrong and I had to get some help to set it right. So I went ahead with my decision to meet Dr Venkat Ram Prasad at Sri Sri Holistic Hospital.

Before we move on to understand how Neal’s surgery went on, let’s find out what ACL is and how it works in our body.

Neal’s surgery

What is ACL?

The ACL is a thick strip of tissue that joins the thigh bone (femur) to the shinbone (tibia) at the knee joint.

It is diagonally located from the femur running into the knee and stabilises the knee joint. It also helps the lower leg to move back-and-forth.

Common ACL injuries and possible reasons

Knee injuries mostly occur during sports such as skiing, tennis, squash and football. ACL injuries are the most common type of knee injuries. Almost 40% of all ACL injuries happen during sports.

Common causes of an ACL injury include:

  • Incorrect landing from a jump
  • sudden change in direction
  • stopping suddenly
  • having a collision, such as during a football tackle

If the ACL is torn, the knee becomes lose, and its range of movement becomes unstable. This results in difficulty in some movements. Some sports may be impossible to play.

Before we look into the procedure of the ACL surgery, let’s see how the ACL is placed in our body and how it functions.

To keep the joint stable, a set of four ligaments keep the knee in a hinge-like position while you move. There are two ligaments on either side of your knee joint. These two ligaments connect the femur and the tibia and limit the movement of the tibia (leg). The other two ligaments, the anterior and posterior cruciate ligaments (ACL & PCL) connect from your base of the femur to the top of the tibia.  These two ligaments cross each other and restrict twisting movements as well as forward and backwards movements of the knee.

Any of these ligaments can be torn during sports of play. Once torn, the ligament cannot regenerate or repair itself.

Deciding to get an ACL surgery done 

  • The decision of getting an ACL surgery depends on the degree of damage caused to your anterior cruciate ligament (ACL).
  • If your knee doesn’t feel unstable and your lifestyle is not a very active one, then you need not have an ACL surgery.
  • However, it is important to know that delaying the surgery can result in further damage to your knee over time.

The Procedure

The ACL reconstruction operation is a one-hour outpatient procedure. The procedure is done through a few tiny incisions.

ACL injury

  • One is made to insert a small camera and to deliver fluid to establish a clear view of the joint.
  • One or two additional incisions are made on the sides of your kneecap to give access to the joint
  • Another tiny incision is done to fix the newly grafted ACL in place.
  • The damaged ACL is removed
  • The surgeon inspects if there is any further damage
  • Then the doctor uses a device called a ‘retro flip cutter’ to create a tunnel through the femur and into the knee joint
  • A tunnel is formed through the tibia also, into the knee joint from below.

     ACL surgery

  • The surgeon then harvests a portion of your hamstring tendons (muscle tissue from the back-side of your thigh) to use as the ACL graft.
  • Using your hamstring tissue reduces the possibility of damage to your ACL again.
  • The hamstring tissues regenerate over time.
  • The harvested hamstring is placed through the upper hole into the lower hole as a replacement to the original ACL.
  • A small hook will anchor the upper end of the graft, and a screw is placed to stabilise the lower end.
  • The screw is usually bile absorbable and gets incorporated into your bone over time.
  • This hamstring graft grows stronger, leaving a new healthy ACL growing over time.

    Recovering from the surgery

Recovering from the surgery

It usually takes around six months to recover from a reconstructive ACL surgery. However, it could also extend up to a year before you can return to proper training for your sport. Your doctor and physiotherapist might suggest you certain exercises with which your recovery shall become easy and faster. You must make sure to regularly follow the instructions given by your doctor.

Neal had his surgery and is right now in the third month of his recovery. Neal is very passionate about tennis and is waiting to get back to the sport in the next few months.

About Doctor:

Dr. Venkat Ram Prasad Vallamshetla is one of the best orthopedic surgeon in Hyderabad. He has done his MBBS, MS Ortho (OSM), MRCS (Edin) and FRCS (Trauma & Orth) from Edinburgh. He has additionally undergone training and has worked in Birmingham for over 12 years with a specialization in Joint Replacement, arthroscopic surgery, sports injuries.

About Hospital:

Sri Sri Holistic Hospital is a leading 100 bedded multi specialty hospital in Nizampet, Kukatpally, Hyderabad. Sri Sri Holistic Hospital provides high standards of healthcare with a combination of advanced technology and state of art clinical expertise. With more than 52 Internationally experienced doctors and 400+ staff, we served at least 50,000 patients so far.