Ligament Reconstruction in Singapore: Benefits, Risks & Recovery
Anterior Cruciate Ligament (ACL) reconstruction surgery is a procedure to rebuild the vital ligament in the centre of your knee. This surgery is for individuals suffering from an ACL tear that causes knee instability, pain, or an inability to return to sports. Dr. Andrew Dutton’s clinic in Singapore offers a specialised, patient-focused approach to ACL repair, aiming to restore function and help you return to your active life.
What is Ligament Reconstruction in the Knee?
Ligaments are tough, connective tissues that support the knee and keep it in place during movement. Knee Ligament Reconstruction is a kind of surgery used to treat damaged ligaments when non-surgical remedies fail to improve a patient’s symptoms.
The knee has four ligaments including the Anterior Cruciate Ligament (ACL), which is in the centre of the knee and controls the forward movement of your shin. The Posterior Cruciate Ligament (PCL) is also in the centre and controls the shin’s backward movement. The Lateral Collateral Ligament (LCL) stabilises your outer knee, while the Medial Collateral Ligament (MCL) keeps your inner knee stable.
These tissues, particularly the ACL, are usually damaged during sports, and when they are, your knee feels unstable and you won’t be able to turn, pivot or twist. Ligament reconstruction tightens the knee and re-stabilises it, avoiding further injury and allowing you to get back into action. If left untreated, a damaged ACL could lead to meniscus tears and early knee arthritis.
What is ACL Reconstruction Surgery?
The Anterior Cruciate Ligament (ACL) is a crucial ligament that provides stability to your knee joint. An ACL injury, particularly a full ACL tear, can compromise the knee’s function. ACL reconstruction surgery is a procedure where a surgeon replaces the torn ligament with a tissue graft. This ligament reconstruction aims to restore knee stability and help patients regain their previous level of function.
Signs You Might Need ACL Surgery
An ACL injury can present with several distinct symptoms. You may be a candidate for surgery if you experience:
- A distinct “popping” sound or sensation at the time of injury
- Significant knee swelling that appears within a few hours
- A persistent feeling of instability, where the knee feels like it might “give way”
- An inability to continue or return to sports that involve pivoting and sudden stops
The ACL Reconstruction Procedure
The journey for an ACL reconstruction procedure is a structured process:
- Diagnosis: The process begins with a thorough physical examination and is often confirmed with imaging tests like an MRI to assess the extent of the tear.
- Pre-operative Preparation: Before surgery, you may undergo physiotherapy to reduce swelling and improve your knee’s range of motion, which can contribute to a better surgical outcome.
- Surgical Technique: Dr. Dutton typically performs this procedure using a minimally invasive arthroscopic technique. This involves small incisions to insert a camera and specialised tools to perform the ligament reconstruction.
- Graft Options: The torn ACL is replaced with a graft, which can be sourced from your own hamstring, patellar tendon, or from a donor (allograft). The best option will be discussed with you.
Recovery Timeline & Aftercare
Post-operative care is crucial for a successful outcome.
- What to expect post-surgery: Expect some initial swelling and pain, which will be managed with medication. You will use crutches and a knee brace to protect the new graft.
- Physical therapy requirements: A dedicated physiotherapy programme is essential. It will start with gentle motion exercises and progressively build strength and stability in the knee.
- Estimated return to work or sports: A return to desk work may be possible within a couple of weeks, but returning to sports can take nine months or more to ensure the graft has healed fully.
- Tips for a faster recovery: Adhere closely to your physiotherapy plan, manage swelling, maintain a healthy diet, and avoid activities that could compromise the healing graft.
Risks & Considerations
While ACL reconstruction has a high success rate, it is important to be aware of potential complications. These can include infection, blood clots, knee stiffness, and issues with graft healing. Being transparent about these risks is key to building trust and ensuring you can make an informed decision.
Choosing the Right Surgeon for Knee Surgery
When selecting a surgeon for a knee operation, it’s advisable to look for professionals who are members of prominent orthopaedic associations, as this often signifies experience and adherence to modern standards. Reviewing their published research or academic contributions can also be insightful. Furthermore, learning about the outcomes of previous patients who underwent the same procedure can help inform your choice.
Note that content on this page is for informational and educational purposes only. Any decisions regarding medication or medical treatments must be made only after a thorough consultation with a qualified medical professional.
For informational purposes: A/Professor Andrew Dutton is a Harvard fellowship-trained orthopaedic surgeon. Dr Dutton holds international affiliations as a Fellow of the American Academy of Orthopaedic Surgeons (AAOS) and a member of the American Association of Hip and Knee Surgeons (AAHKS).
For minimally invasive ligament repairs and other personalised therapeutic interventions, visit A/Professor Andrew Quoc Dutton. He is a Harvard fellowship-trained orthopaedic surgeon practising at Mount Elizabeth Hospital, Singapore with subspecialty interests in arthroscopic/keyhole surgeries, sports injuries, knee replacements, and cartilage regeneration.
Frequently Asked Questions on Ligament Reconstruction
Who needs Ligament Reconstruction?
Athletes who play basketball, football or soccer, rugby, tennis, squash and skiing are especially prone to ACL damage because their knees often turn in a direction opposite the way their feet are planted. These sports also involve a sudden change in speed or direction, as well as physical contact with the side of the knee.
When the athlete twists, the ACL may get torn or stretched too far, also if the athlete lands awkwardly after a jump. This is when a loud popping sound is heard and the knee buckles.
Ligament reconstruction is recommended for active adult patients who rely on knee stability for work or sports. It might also be necessary for people with Trochlear Dysplasia or an unstable kneecap.
How is Ligament Reconstruction done?
There is a possibility that surgery won’t be needed if the knee remains stable overall. In such cases, non-surgical treatments such as Protecting, Resting, Icing, Compressing and Elevating the knee or PRICE therapy followed by physical therapy may be recommended.
But if ligament reconstruction is deemed necessary, it will be done under general anaesthesia. The surgeon makes two small incisions around the knee and inserts an arthroscope, or tiny video camera, into one of them. To get a clearer view, the surgeon pumps in a sterile solution to expand the knee, and proceeds to remove the damaged ligament.
A healthy piece of tendon will then be taken from the kneecap or hamstring to replace the damaged ligament. To do this, small holes will be drilled into the bones surrounding the knee joint where the tendon will be grafted and held in place with screws, allowing the replacement ligament to fuse with the bone.
Are there any risks when having Ligament Reconstruction done?
People who have ligament reconstruction done run the risk of bleeding, infection, blood vessel or nerve damage, and blood clots in the legs or the lungs. They may have further pain, numbness or swelling in their knee and, as the reconstructed tendon stretches, experience a decrease in their range of movement
It’s also possible for the graft to fail, become loose, or become injured again. The patient may also experience crepitus, or a grating, cracking feeling in the kneecap.
How do you prepare for Ligament Reconstruction?
To determine whether ligament reconstruction surgery is required, the knee will be thoroughly examined via X-rays, MRI’s and arthroscopy. The surgeon also often uses the Lachman’s test or the pivot shift test to check whether the ACL is still intact: if the ACL is torn, the shin will move too far forward.
Before the procedure can be done, the patient may need to wait for swelling to subside and to be able to move the knee within its full range of movement again. It takes about three weeks for the full range of movement to come back after the injury, but without it, recovering from ligament reconstruction may take longer.
The patient might also have to wait for both front and back thigh muscles to become strong enough for the procedure. Physical therapy might be recommended, which will include exercises such as stretching exercises for leg flexibility and low-impact activities such as cycling or swimming. Sports and strenuous movements such as jumping, twisting and turning must be avoided.
How can you speed up recovery from Ligament Reconstruction?
Some people who have had ligament reconstruction still have pain and some knee instability, and may take around six months to fully recover. However, being able to play sports at the same level before the injury took place could take about a year.
To facilitate your recovery, care for your wound by washing it with mild soap and warm water. Be sure to keep your bandages clean and wear the cuff or waterproof bandage you may be given. The cuff might contain iced water to help keep swelling down, so take care that the cuff doesn’t leak. The cuff may be substituted by placing an ice pack wrapped in a towel on your knee.
If you notice swelling and redness or painful bruises on your shin or ankle, this could be because of leaking blood and fluid inside your knee. This should go away after a week or so, but if it doesn’t, be sure to let your surgeon know, and to take pain medications as directed.
Following the physical therapy programme given by your surgeon or therapist can also help speed up recovery. The exercises can start after the procedure and continue at home, and may include bending, raising and strengthening your leg. If you’re not sure about how to do any of the exercises, ask your surgeon or physical therapist to make sure you’re doing them correctly.
When using crutches, which will probably have to be used for about two weeks, make sure you put as much weight on your injured leg as necessary. Keep your leg elevated as much as possible by resting your foot on pillows when in bed.
Pain is your body’s way of telling you that something is not right. Don’t just brush it off and risk the chance of compromising your movement and interupting your daily activities. Get it checked today for the right intervention the soonest possible time. Book your appointment with Dr. Dutton, here.
How long does it take to heal from an ACL tear?
While the initial healing takes weeks, a full recovery with a return to high-impact sports can take nine to twelve months or longer, depending on individual progress in rehabilitation.
Can an ACL tear heal on its own?
A complete ACL tear does not typically heal on its own due to its location within the knee joint and poor blood supply.
Can I still walk with a torn ACL?
Yes, many people can walk with a torn ACL. However, they may experience episodes of instability, especially with quick movements or on uneven surfaces.
Can I bend my knee with a torn ACL?
Immediately after the injury, pain and swelling can limit motion. After the initial phase, most people can regain the ability to bend their knee, but instability may remain.
Can I live normally with an ACL tear?
It is possible to live with an ACL tear, particularly with a less active lifestyle. However, for those wishing to return to sports or physically demanding activities, surgery is often recommended to restore stability and prevent further knee damage.
Knee Replacement
Knee Pain Treatment
Ligament Reconstruction
Complex Or Primary revision (REDO) Knee replacement
Cartilage Regeneration (microfracture, Cartilage Transplantations and trials)
Arthrocopy or keyhole surgery for sports injuries knee (ACL and miniscal injuries)
Knee Osteoarthritis treatment
Knee Arthroscopy
Miniscus Tear treatment
Cartilage injury treatment
ACL Injury treatment
A/Professor Andrew Quoc Dutton
Elite Orthopaedics Pte LtdTelephone: (+65) 68368000
Email: info@eliteortho.com.sg
Fax: (+65) 68367617
Location: 3 Mt Elizabeth Medical Centre
Level 12. Suite 12-10
Singapore 228510
Understanding your orthopaedic consultation
A quick guide to help you feel informed and prepared before your visit.
Knee Replacement
Knee Pain Treatment
Ligament Reconstruction
Complex Or Primary revision (REDO) Knee replacement
Cartilage Regeneration (microfracture, Cartilage Transplantations and trials)
Arthrocopy or keyhole surgery for sports injuries knee (ACL and miniscal injuries)
Knee Osteoarthritis treatment
Knee Arthroscopy
Miniscus Tear treatment
Cartilage injury treatment
ACL Injury treatment
Anterior Cruciate Ligament (ACL) reconstruction surgery is a procedure to rebuild the vital ligament in the centre of your knee. This surgery is for individuals suffering from an ACL tear that causes knee instability, pain, or an inability to return to sports. Dr. Andrew Dutton’s clinic in Singapore offers a specialised, patient-focused approach to ACL repair, aiming to restore function and help you return to your active life.
What is Ligament Reconstruction in the Knee?
Ligaments are tough, connective tissues that support the knee and keep it in place during movement. Knee Ligament Reconstruction is a kind of surgery used to treat damaged ligaments when non-surgical remedies fail to improve a patient’s symptoms.
The knee has four ligaments including the Anterior Cruciate Ligament (ACL), which is in the centre of the knee and controls the forward movement of your shin. The Posterior Cruciate Ligament (PCL) is also in the centre and controls the shin’s backward movement. The Lateral Collateral Ligament (LCL) stabilises your outer knee, while the Medial Collateral Ligament (MCL) keeps your inner knee stable.
These tissues, particularly the ACL, are usually damaged during sports, and when they are, your knee feels unstable and you won’t be able to turn, pivot or twist. Ligament reconstruction tightens the knee and re-stabilises it, avoiding further injury and allowing you to get back into action. If left untreated, a damaged ACL could lead to meniscus tears and early knee arthritis.
What is ACL Reconstruction Surgery?
The Anterior Cruciate Ligament (ACL) is a crucial ligament that provides stability to your knee joint. An ACL injury, particularly a full ACL tear, can compromise the knee’s function. ACL reconstruction surgery is a procedure where a surgeon replaces the torn ligament with a tissue graft. This ligament reconstruction aims to restore knee stability and help patients regain their previous level of function.
Signs You Might Need ACL Surgery
An ACL injury can present with several distinct symptoms. You may be a candidate for surgery if you experience:
- A distinct “popping” sound or sensation at the time of injury
- Significant knee swelling that appears within a few hours
- A persistent feeling of instability, where the knee feels like it might “give way”
- An inability to continue or return to sports that involve pivoting and sudden stops
The ACL Reconstruction Procedure
The journey for an ACL reconstruction procedure is a structured process:
- Diagnosis: The process begins with a thorough physical examination and is often confirmed with imaging tests like an MRI to assess the extent of the tear.
- Pre-operative Preparation: Before surgery, you may undergo physiotherapy to reduce swelling and improve your knee’s range of motion, which can contribute to a better surgical outcome.
- Surgical Technique: Dr. Dutton typically performs this procedure using a minimally invasive arthroscopic technique. This involves small incisions to insert a camera and specialised tools to perform the ligament reconstruction.
- Graft Options: The torn ACL is replaced with a graft, which can be sourced from your own hamstring, patellar tendon, or from a donor (allograft). The best option will be discussed with you.
Recovery Timeline & Aftercare
Post-operative care is crucial for a successful outcome.
- What to expect post-surgery: Expect some initial swelling and pain, which will be managed with medication. You will use crutches and a knee brace to protect the new graft.
- Physical therapy requirements: A dedicated physiotherapy programme is essential. It will start with gentle motion exercises and progressively build strength and stability in the knee.
- Estimated return to work or sports: A return to desk work may be possible within a couple of weeks, but returning to sports can take nine months or more to ensure the graft has healed fully.
- Tips for a faster recovery: Adhere closely to your physiotherapy plan, manage swelling, maintain a healthy diet, and avoid activities that could compromise the healing graft.
Risks & Considerations
While ACL reconstruction has a high success rate, it is important to be aware of potential complications. These can include infection, blood clots, knee stiffness, and issues with graft healing. Being transparent about these risks is key to building trust and ensuring you can make an informed decision.
Choosing the Right Surgeon for Knee Surgery
When selecting a surgeon for a knee operation, it’s advisable to look for professionals who are members of prominent orthopaedic associations, as this often signifies experience and adherence to modern standards. Reviewing their published research or academic contributions can also be insightful. Furthermore, learning about the outcomes of previous patients who underwent the same procedure can help inform your choice.
Note that content on this page is for informational and educational purposes only. Any decisions regarding medication or medical treatments must be made only after a thorough consultation with a qualified medical professional.
For informational purposes: A/Professor Andrew Dutton is a Harvard fellowship-trained orthopaedic surgeon. Dr Dutton holds international affiliations as a Fellow of the American Academy of Orthopaedic Surgeons (AAOS) and a member of the American Association of Hip and Knee Surgeons (AAHKS).
For minimally invasive ligament repairs and other personalised therapeutic interventions, visit A/Professor Andrew Quoc Dutton. He is a Harvard fellowship-trained orthopaedic surgeon practising at Mount Elizabeth Hospital, Singapore with subspecialty interests in arthroscopic/keyhole surgeries, sports injuries, knee replacements, and cartilage regeneration.
Frequently Asked Questions on Ligament Reconstruction
Who needs Ligament Reconstruction?
Athletes who play basketball, football or soccer, rugby, tennis, squash and skiing are especially prone to ACL damage because their knees often turn in a direction opposite the way their feet are planted. These sports also involve a sudden change in speed or direction, as well as physical contact with the side of the knee.
When the athlete twists, the ACL may get torn or stretched too far, also if the athlete lands awkwardly after a jump. This is when a loud popping sound is heard and the knee buckles.
Ligament reconstruction is recommended for active adult patients who rely on knee stability for work or sports. It might also be necessary for people with Trochlear Dysplasia or an unstable kneecap.
How is Ligament Reconstruction done?
There is a possibility that surgery won’t be needed if the knee remains stable overall. In such cases, non-surgical treatments such as Protecting, Resting, Icing, Compressing and Elevating the knee or PRICE therapy followed by physical therapy may be recommended.
But if ligament reconstruction is deemed necessary, it will be done under general anaesthesia. The surgeon makes two small incisions around the knee and inserts an arthroscope, or tiny video camera, into one of them. To get a clearer view, the surgeon pumps in a sterile solution to expand the knee, and proceeds to remove the damaged ligament.
A healthy piece of tendon will then be taken from the kneecap or hamstring to replace the damaged ligament. To do this, small holes will be drilled into the bones surrounding the knee joint where the tendon will be grafted and held in place with screws, allowing the replacement ligament to fuse with the bone.
Are there any risks when having Ligament Reconstruction done?
People who have ligament reconstruction done run the risk of bleeding, infection, blood vessel or nerve damage, and blood clots in the legs or the lungs. They may have further pain, numbness or swelling in their knee and, as the reconstructed tendon stretches, experience a decrease in their range of movement
It’s also possible for the graft to fail, become loose, or become injured again. The patient may also experience crepitus, or a grating, cracking feeling in the kneecap.
How do you prepare for Ligament Reconstruction?
To determine whether ligament reconstruction surgery is required, the knee will be thoroughly examined via X-rays, MRI’s and arthroscopy. The surgeon also often uses the Lachman’s test or the pivot shift test to check whether the ACL is still intact: if the ACL is torn, the shin will move too far forward.
Before the procedure can be done, the patient may need to wait for swelling to subside and to be able to move the knee within its full range of movement again. It takes about three weeks for the full range of movement to come back after the injury, but without it, recovering from ligament reconstruction may take longer.
The patient might also have to wait for both front and back thigh muscles to become strong enough for the procedure. Physical therapy might be recommended, which will include exercises such as stretching exercises for leg flexibility and low-impact activities such as cycling or swimming. Sports and strenuous movements such as jumping, twisting and turning must be avoided.
How can you speed up recovery from Ligament Reconstruction?
Some people who have had ligament reconstruction still have pain and some knee instability, and may take around six months to fully recover. However, being able to play sports at the same level before the injury took place could take about a year.
To facilitate your recovery, care for your wound by washing it with mild soap and warm water. Be sure to keep your bandages clean and wear the cuff or waterproof bandage you may be given. The cuff might contain iced water to help keep swelling down, so take care that the cuff doesn’t leak. The cuff may be substituted by placing an ice pack wrapped in a towel on your knee.
If you notice swelling and redness or painful bruises on your shin or ankle, this could be because of leaking blood and fluid inside your knee. This should go away after a week or so, but if it doesn’t, be sure to let your surgeon know, and to take pain medications as directed.
Following the physical therapy programme given by your surgeon or therapist can also help speed up recovery. The exercises can start after the procedure and continue at home, and may include bending, raising and strengthening your leg. If you’re not sure about how to do any of the exercises, ask your surgeon or physical therapist to make sure you’re doing them correctly.
When using crutches, which will probably have to be used for about two weeks, make sure you put as much weight on your injured leg as necessary. Keep your leg elevated as much as possible by resting your foot on pillows when in bed.
Pain is your body’s way of telling you that something is not right. Don’t just brush it off and risk the chance of compromising your movement and interupting your daily activities. Get it checked today for the right intervention the soonest possible time. Book your appointment with Dr. Dutton, here.
How long does it take to heal from an ACL tear?
While the initial healing takes weeks, a full recovery with a return to high-impact sports can take nine to twelve months or longer, depending on individual progress in rehabilitation.
Can an ACL tear heal on its own?
A complete ACL tear does not typically heal on its own due to its location within the knee joint and poor blood supply.
Can I still walk with a torn ACL?
Yes, many people can walk with a torn ACL. However, they may experience episodes of instability, especially with quick movements or on uneven surfaces.
Can I bend my knee with a torn ACL?
Immediately after the injury, pain and swelling can limit motion. After the initial phase, most people can regain the ability to bend their knee, but instability may remain.
Can I live normally with an ACL tear?
It is possible to live with an ACL tear, particularly with a less active lifestyle. However, for those wishing to return to sports or physically demanding activities, surgery is often recommended to restore stability and prevent further knee damage.
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