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What is the care after an ACL reconstruction?

Dr Mathew Varghese
Head, Department of Orthopaedics,
St. Stephens Hospital,
New Delhi

Q: I have just undergone an ACL reconstruction surgery in my knee and am recuperating. Reconstruction was done by hamstring tendon graft. In addition, total removal of medial meniscus was also done. I am not a professional sportsman, though the injury was due to sports. Could you please clarify the following for me: 1. What is the time required for the reconstructed ACL to bind itself to the tibia and femur? 2. What are the precautions to be taken when I commence physiotherappy post-removal of cast? 3. What are the limitations on my knee due to removal of medial meniscus? 4. What is the life of reconstructed ACL? 5. Any specific advise that would help me to conserve the health of my knee. 6. Does consumption of nutritional medicine with glucosamine as prime content improve the health of the knee? 7. Could you give me the name of any specific site on the net that could educate me further?

A:To answer your questions:1. It takes about 9 months for the reconstructed ACL to bind itself firmly to tibia and femur. This means it cannot be stressed fully before 8 - 9 months. 2. Essentially precautions relate to avoiding any stress that is likely to rupture the reconstructed ligament. This could be a break at the binding site or break through the substance of the ligament. Therefore, all sports activities where you need to bend your knee and pivot around your leg should be avoided. If you are not an athlete then common activity like driving a motor cycle or a scooter should be avoided. 3. Menisci function as washers that absorb shocks at the knee. This has a protective function on the cartilage of the knee. Therefore, removal of meniscus is likely to lead to early degeneration of the knee. 4. If the reconstruction is successful, then it should last you all your life. Unless, you get injured again. 5. Regular quadriceps exercise is the best way to protect your knee. 6. As far as I am aware, glucosamine does not protect your knee or heal degenerating knees. 7. I am sure you could look up google search on problems of the knee. There are sites that are related to specific joints or general sites related to specialty of Orthopaedics. Try www.kneeshoulder.com.