Everything You Need To Know About ACL Reconstruction Surgery

ACL surgery is often considered when there is a complete tear of the anterior cruciate ligament (ACL), especially in active individuals or those involved in sports. This page provides a full overview of ACL reconstruction, including who may need surgery, what to expect before and after the procedure, possible complications, and cost considerations in Singapore.

What Is ACL Reconstruction?

ACL reconstruction is a type of surgery that replaces a torn anterior cruciate ligament in the knee. The goal is to restore stability and function to the joint. During the procedure, the damaged ligament is removed and replaced with a tissue graft, often taken from the patient’s own body or a donor. ACL reconstruction is commonly considered for individuals who want to return to physical activity or sports that involve pivoting, jumping, or sudden direction changes.

Who Is a Suitable Candidate for ACL Surgery?

Am I the right candidate for ACL surgery?

You may be considered for ACL surgery if you:

Signs Indicating You May Need ACL Surgery

Persistent Knee Instability:

If you frequently experience episodes of the knee giving way or feeling unstable despite conservative treatments like physical therapy, it may suggest an ACL injury requiring surgical intervention.

Recurrent Knee Swelling:

While minor swelling may resolve with rest and ice, persistent or recurrent swelling, accompanied by pain and limited range of motion, may indicate the need for ACL reconstruction surgery to address the underlying structural damage.

Functional Limitations:

Is your knee injury significantly impacting your quality of life, inhibiting your ability to engage in physical activities you enjoy, or compromising your performance on the sports field? It might be time to consult a specialist about ACL reconstruction. This surgical option can restore stability and function to your knee, allowing you to get back to the active lifestyle you love.

Timing Your ACL Surgery:Key Factors to Consider Knee

Swelling and Inflammation:

Significant swelling should be managed and reduced through rest, ice, compression, and elevation (RICE) before surgery to improve surgical outcomes and reduce complications.

Presence of Additional Knee Injuries:

Before proceeding with ACL surgery, it is crucial to assess whether there are other injuries, such as meniscus tears or ligament damage to ensure a more effective and comprehensive recovery process.

Level of Knee Pain:

Severe pain that interferes with daily activities or persists despite conservative treatments might indicate the need for earlier surgical intervention.

Range of Motion and Muscle Control:

Achieving a good range of motion and adequate muscle strength prior to surgery can lead to effective post-operative results and rehabilitation process.

Understanding How ACL Reconstruction Surgery Works

In ACL reconstruction surgery, the damaged ligament is replaced using a graft from one of two sources:

Autograft:

This involves using a portion of the patient’s own tissue, such as the hamstring tendon, quadriceps tendon, patellar tendon, or iliotibial band.

Allograft:

This involves using donor tissue from a human organ donor.

 

The choice of graft depends on your individual needs, though allografts are generally not recommended for young patients due to a higher risk of reinjury and graft failure. The surgery is then performed using minimally invasive arthroscopic techniques. This involves the use of fibre optics, small incisions, and specialised instruments. That said, a slightly larger incision may also be necessary to obtain the tissue graft.

What Should I Expect Before and After ACL Reconstruction Surgery?

Before Surgery

After Surgery

Are There Some Possible Complications After an ACL Surgery?

Growth plate injury

In children and adolescents, special care is taken if growth plates are still open. Improper technique could affect future bone development.

Extensor mechanism failure

Rarely, the mechanism that allows the knee to straighten may become weak or disrupted, especially if certain graft types are used.

Stiffness

Reduced range of motion can occur if early rehabilitation is delayed or the joint is not moved regularly.

Infection

As with any surgery, infection is a risk. Proper wound care and early detection are important for managing this.

ACL Reconstruction Post-Surgery Care

Recovery Room:

After your operation, you will be taken to the recovery room, where nurses will closely monitor your blood pressure, breathing, and heart rate. Please inform the nurse if you experience any nausea or pain.

Managing Discomfort:

Experiencing some discomfort after surgery is normal. You will be given pain relief medication to help manage this and aid in your recovery.

Diet and Hydration:

Once the effects of anaesthesia wear off, it is important to stay hydrated and eat a balanced diet to support your recovery.

Wound Care:

Your operated leg will be carefully bandaged and kept elevated to support healing. For pain and swelling reduction, an ice wrap will be applied to your knee for 24 to 72 hours. Throughout the first week, maintain elevation and use ice wraps as necessary. Additionally, a brace will be provided for knee protection. Keep in mind that adjustments or removal should be done with guidance from your surgeon or physiotherapist.

Elimination Needs:

Initially, you will need to rest in bed and use a bedpan or urinal for elimination purposes.

Rehabilitation and Exercises:

Your surgeon and physiotherapist will discuss your rehabilitation plan, which may include gentle hip and knee bending exercises within your pain limits.

Length of Stay:

The typical hospital stay for ACL reconstruction is two to three days, but this can vary based on recovery needs.
Doctor holding the ankle of the patient

ACL Tear Recovery Timeline

The process of recovery can vary based on factors such as the severity of the injury, the surgical method used, and the progress made during physical therapy. Here is a general timeline:

For individuals undergoing ACL reconstruction, adherence to physical therapy significantly influences recovery outcomes.

ACL Reconstruction Surgery Costs in Singapore

The costs of ACL surgery in Singapore can vary depending on the type of hospital (public vs private), surgical method, and length of hospital stay. Here’s a general guide:

Setting Estimated Range (SGD)
Public Hospital (Subsidised) $1,200 – $4,000
Public Hospital (Private Class) $6,000 – $10,000
Private Hospital $13,000 – $18,000

Note: At public hospitals, wait times for surgery may be longer, and you may not be able to choose your preferred surgeon.

Insurance and Subsidy Options

Insurance Coverage

If you hold private health insurance or corporate coverage, part or all of your surgery and hospital stay may be claimable. Speak with our clinic or your insurer to check eligibility.

Medisave and MediShield Life

Singaporeans and PRs may use Medisave to offset eligible surgical costs. MediShield Life can also provide coverage, especially for B2 or C class wards in public hospitals. Additional coverage under Integrated Shield Plans may apply for private hospital stays.

Everything You Want to Know About ACL Treatment

Are there minimally invasive options for ACL surgery?

Yes, ACL surgery is common. This technique uses small incisions and arthroscopic tools, reducing recovery time and minimising scarring compared to traditional open surgery.

Physiotherapists may recommend a progressive plan that includes mobility, balance, and strength training. Exercises will depend on your recovery phase and should be followed under supervision.
Recovery depends on your activity level before surgery, how well you follow rehabilitation guidance, and your overall health. Staying consistent with physiotherapy plays an important role.
Look for an ACL surgeon who is familiar with your condition and has managed similar cases. It’s also helpful to discuss your treatment goals during the consultation to see if their approach aligns with your needs.
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