ACL Reconstruction Surgery

Anterior Cruciate Ligament (ACL) Reconstruction

ACL reconstruction is a surgical procedure to repair a torn anterior cruciate ligament (ACL), which is a key ligament in the knee. The ACL connects the thigh bone to the shinbone and helps maintain the knee joint. It is one of two ligaments that cross the center of the knee.

The majority of ACL injuries occur as a result of sports or fitness activities that place stress on the knee, like abruptly slowing down and altering course (cutting), pivoting while keeping your foot firmly on the ground, landing improperly after a jump, abruptly halting, etc. Some may benefit from physical therapy to rehabilitate an ACL injury.

ACL reconstruction is usually recommended if an individual is a sportsperson who wants to pursue his career, especially if it involves cutting, jumping, or rotating. The reconstruction also helps if there are multiple ligaments that have been injured, etc. Generally, people playing sports like football, soccer, basketball, and volleyball, are prone to ACL injuries

What is covered in the above mentioned cost for surgery?

This price includes surgery cost, doctor’s fee, standard prescribed tests and all standard expenses required at the hospital.

India, a Preferred Destination for ACL Reconstruction

Due to the long-term evolution of the Indian medical arena, India is by far one of the most popular medical tourism destinations. Doctors in India are highly skilled and knowledgeable, particularly when it comes to ACL surgery. 

ACL reconstruction surgery cost in India is one-sixth of what it would cost in the United States, the United Kingdom, or Thailand. The cost varies depending on the method, facility, where the surgery is performed, and the surgeon.  

The patient will be able to regain full function of the knee and return to former sports activities after receiving ACL repair. Patients can benefit from the precision and international grade surgery provided by India’s leading orthopedic doctors.

Indian Medical Visa (India e-Medical Visa)

By default, the Indian government allows a medical visa to be valid for 60 days. However, India’s new visa policy allows the paper-based medical visa to be extended for up to 180 days.

The procedure for obtaining an Indian Medical Visa is filling out an Indian Visa Application Form online. It will only take a couple of minutes. Then you have to make the payment through PayPal, and provide the appropriate documents for treatment, such as a letter from a hospital. This process takes 72 hours to complete, and an accepted Visa is emailed to the concerned person.

Nationals of e-Visa India-eligible countries who require a Medical Visa may apply online using the online e-Visa India application form at https://www.indiavisa-online.org. A letter from the hospital in India where they intend to receive treatment is required.

The individual may also be requested to show proof that they have enough money to cover their medical expenses in India. They may also be asked to produce a return travel ticket to their native country once the medical treatment is completed. These papers can be faxed or emailed to the Help Desk, or they can be submitted to the website later.

One of the benefits of the Indian Medical Visa is that, unlike the 30-day Tourist Visa, which is only valid for two entries, it enables three entries into India during its 60-day duration. 

The following conditions and requirements of the e-Visa for medical treatment must be understood and remembered as pointers:

• The Indian e-Medical Visa is valid for 60 days from the date of arrival in India.
• The e-Medical India Visa allows you to visit India three times.
• Individuals can apply for a Medical Visa up to three times per year.
• It is not possible to extend the electronic Medical Visa.
• This visa is not convertible and cannot be changed to a tourist or business visa.
• It can’t be used to enter protected or restricted sites.
• Patients must show proof of financial support for their stay in India.
• During your trip to the airport, the patient must have a PDF or paper copy with you.
• On the e-Medical India Visa, patients can request a return ticket.
• There is no such thing as a group medical visa for India; each applicant must apply independently.
• On the day of arrival in India, the passport must be valid for at least six months.
• Individuals must have two blank pages in their passports so that immigration and border control personnel can stamp their passports at the airport for entry and exit.
• A regular passport is required to be presented. Indian Medical Visas cannot be obtained using diplomatic, service, official or refugee passports.
• Individuals must apply for a paper or conventional India Medical Visa rather than an electronic Medical Visa on the Govt. website if the treatment will continue longer than 180 days.

The website allows a person to apply online, and it will take you 3 to 5 minutes to finish the application. It is recommended that you apply for a Medical Visa in India online rather than visiting an Indian Embassy or High Commission.

ACL Reconstruction Procedure

The need for surgery is determined by the degree of the ACL injury and the patient’s lifestyle. An ACL that has been completely torn will not mend on its own. However, if it is a partial tear then chances are the ligament can recover on its own without requiring surgery.

In order to assess the injury and determine whether a tear is partial or complete, the doctor performs two manual exams:

• The Lachman test: Involves the physician pulling the shin bone away from the thigh bone. The bones will not move or will move just slightly if the ACL is ruptured but still intact.

• The Pivot shift test: The patient lies down on their back as the doctor raises their leg and applies rotational pressure to the knee. The test is negative if the bones do not shift.

It may be recommended to postpone surgery in patients who just have a partial tear and wait to see if the ligament heals without it.

ACL reconstruction surgery for a complete ACL tear is usually scheduled between three and six weeks after the injury occurs. This reduces inflammation in the affected area. Patients who have surgery too early may develop arthrofibrosis, a severe scarring response.

A new ACL is created in ACL reconstruction surgery using a graft of replacement tissue from one of the two sources:

• A patient’s own quadriceps, patellar tendon or hamstring

• An allograft (tissue from an organ donor)

On a case-by-case basis, the type of transplant used for each patient is determined.

ACL reconstruction surgery is a minimally invasive arthroscopic procedure that utilizes a combination of small incisions, small equipment, and fiber optics. However, obtaining the tissue graft necessitates a little larger incision. 

In most situations, a torn ACL cannot be repaired or reattached. The ligament is usually completely rebuilt during ACL surgery. The ACL reconstruction method is the current gold standard for surgically treating a torn ACL. Choosing the proper surgical choice for an ACL injury at the outset can have long-term consequences, therefore doing ACL surgery correctly the first time is crucial.

ACL reconstruction is an outpatient (ambulatory) operation that allows patients to return home the same day.

Pre-operative Procedure For ACL Reconstruction 

The patient checks in at the hospital or surgical center on the day of the surgery, and will be taken to a pre-operative room. Here, after all the vital parameters like temperature, blood pressure, will be monitored and an intravenous (IV) line will be inserted into a vein. This is done to administer fluids and medications.

The patient will then be transported into the operation room and the surgical team will administer general anesthesia. In some places, instead of using general anesthesia, patients undergoing ACL restoration have an epidural nerve block. This epidural is similar to the localized anesthetic used by many women during childbirth.

During The Procedure

The majority of ACL restoration procedures take no more than two hours. The ACL is reconstructed in a few fundamental phases; however they may vary significantly from case to case.

The orthopedic surgeon creates ports of entry for the arthroscope and surgical equipment by making small incisions around the knee joint.

The arthroscope is placed into the knee and a saline solution is delivered to widen the joint’s space. This frees up space for surgical instruments such as the arthroscopic camera, which transmits video to a monitor so the surgeon can look within the knee joint.

The surgeon then assesses the left and right meniscus, as well as the articular cartilage, which surround the torn ACL. The surgeon will repair any lesions in either of these soft tissues.

The graft will then be harvested (unless an allograft is used). A graft is made by cutting a segment of tendon from another region of the patient’s body and attaching it to bone plugs obtained from the patella and tibia at each end. These plugs aid in the stabilization of the graft that will eventually become the replacement ACL.

Using a flexible guide wire, the surgeon inserts the new ACL into the femur and tibia. The bone plugs are held in place by screws. These plugs will mature into the desired shape over time.

To conclude the process, the surgical instruments are withdrawn. The surgeon will use sutures (stitches) to close the wounds and cover the region with a dressing at the end of the procedure. After the procedure, the patient may be able to see images of what the doctor saw and what was done during the surgery.

Post-operative Procedure For ACL Reconstruction

The patient can go home the same day upon recovering from anesthesia. The doctor may prescribe a knee brace after the surgery. Maintain the knee brace on as much as possible to assist keep the knee straight and avoid any unneeded strain.

Following surgery, the doctor will give detailed advice on how to manage swelling and pain. Keeping the leg elevated, applying a cold wrap or ice to the knee, and resting as much as possible are all recommended.

The doctor will prescribe pain medications, to counter the effects of pain post-surgery. If opioids are given, they should only be used for severe pain because they have a high risk of addiction.

The patient may regain a range of motion equal to that of the opposite knee within the first few weeks after surgery. However, in most cases, ACL reconstruction surgery recovery time varies from 8 to 9 months. Athletes may have to wait eight to twelve months or longer to return to their sports.

Tips And Advice

It is critical to keep the surgical area clean and dry once the patient returns home. Bathing instructions will be given by the doctor. During a subsequent appointment visit, the stitches or surgical staples will be removed.

As directed by the doctor, use pain medication for soreness. Aspirin and other pain relievers can raise the risk of bleeding. Take only the medications that have been prescribed by the doctor.

It is advisable to follow the instructions of the doctor for how long to freeze the knee when it’s safe to put weight on it, how long to use crutches, etc. The surgeon will give instructions on details like when to change the wound dressings, when to shower or bathe, and how to handle post-surgery care. 

After ACL reconstruction surgery, progressive physical therapy helps to strengthen the muscles around the knee and increase flexibility. A physical therapist will show how to conduct exercises that can be done at home or with continuing supervision. It is critical to stick to the rehabilitation plan in order to heal properly and achieve the best possible results.

All the instructions given by the surgeon should be followed by the patient to maintain the ACL reconstruction surgery recovery time.  This is because any negligence can put the health of the patient at risk and push the ACL reconstruction surgery recovery time further. If a repaired ACL fails, the only way to fix it is to reconstruct it. This would inevitably be harsh on the pockets of the patients as the ACL reconstruction surgery cost will also be affected.

How Can MyMedTrip.com Help You?

It is natural to be overwhelmed and concerned while traveling to a new place for medical treatment. Throughout the journey, we shall assist the patient and their attendant, and provide a manager for help throughout the whole medical trip. We will also assist in overcoming linguistic barriers.

Should you decide on traveling to India for medical assistance, you may email us at hi@mymedtrip.com or WhatsApp at +91 9818237391. The first consultation arranged by us would be free of cost! Additionally, we also provide visa invitation letters and help in facilitating the medical journey to India.

For any further assistance/queries or questions related to ACL reconstruction as well as services in India, do not hesitate to email us at the aforementioned address. We shall be glad to assist you and help you get well soon.

Frequently Asked Questions about ACL Reconstruction surgery

Is ACL surgery a common procedure?

ACL injuries that necessitate repair or replacement are prevalent, particularly among athletes.

Can ACL injuries be avoided?

Anyone can reduce their chance of ACL injury by doing a power, balance, and agility training drill.

Is it true that female athletes are more prone to ACL injuries?

In particular sports, female athletes had a higher rate of ACL damage than male players, according to statistics. The gender-related divergence could be due to strength of the muscles, control of the neuromuscular system, etc.

How to sleep after ACL surgery?

The patient can sleep on their back or side. Do not rest the knee with a towel or pillow under it. It is very important to keep the knee straight.

Can a patient get an MRI post ACL surgery?

The ACL reconstruction patients are ideal candidates for MRI examination. Chronic instability, acute reinjury, persistent pain limitation of mobility, are all common indications for using MRI in the post-operative ACL patient.

Will my knee ever be the same after ACL surgery?

For the most part, the patient’s range of motion becomes the same 10 years after surgery as it had been two years prior.

Why does the ACL graft get weaker?

Vessels infiltrate the graft, and the body’s cells sweep away the dead cells debris, weakening the graft. The graft is substantially weaker than the natural ACL, and it is vulnerable during activities that put the ACL under stress. The graft is vulnerable to not just rupture but also stretching and elongation during this critical period.

Why is ACL surgery recovery so long?

The ACL, like all ligaments, takes a long period to repair. The reason for this is that ligaments have inadequate vascularization. In other words, there aren’t many blood vessels to supply nourishment to the ligaments, and tissue healing is impossible without nutrients. ACL injuries frequently necessitate a surgical graft.

Can ACL reconstruction be done twice?

A second procedure called a revision ACL reconstruction is done to restore a ruptured ACL. This is a more difficult procedure for the orthopedic surgeon.

Are ACL injuries permanent?

Irrespective of the nature of the injury, the result can be long-lasting or even permanent even after the patient undergoes surgery. But post-surgery the uneasiness can be reduced to a great length.