An ACL injury is a tear or sprain of the anterior cruciate ligament (ACL) – one of the strong bands of tissue that help connect your thigh bone (femur) to your shinbone (tibia). An ACL injury occurs at the instant of tissue failure as the athlete suddenly feels a pop, shift, buckle, or giving-way event. At onset and thereafter, the memory of this life-changing event may influence future career, education, vocation, and life sporting activity choices. Memory of this event often becomes a recurring discussion topic for the remainder of a person’s life.
You all must have heard of Rishabh Pant’s ACL surgery after he survived the car accident. It took him almost 2 years to make his comeback in cricket after undergoing surgery for multiple ligament tears in his right knee. This makes one question how long it takes to recover from ACL surgery.
What is ACL Surgery?
ACL reconstruction surgery is a procedure designed to restore stability to the knee after an ACL tear, which is commonly caused by sports injuries, falls, or sudden changes in direction. The surgery typically involves removing the damaged ligament and replacing it with a graft, which can be taken from the patient’s own body or a donor.
The surgical process generally begins with anesthesia, followed by arthroscopic techniques, which involve small incisions and the use of a camera to guide the surgeon. The graft is then securely attached to the femur and tibia, allowing for the rebuilding of a functional ACL. Post-surgery, patients typically go through a rehabilitation program to regain strength and mobility. While the recovery timeline varies, most can return to sports and regular activities within several months, depending on their adherence to rehabilitation and the severity of the injury.
Factors Affecting Recovery Time Post ACL Surgery
Various factors affect the recovery time after ACL surgery. These include the following:
Pre-habilitation
Patients engaging in a “prehab” exercise program before surgery are reported to recover better.
Surgical Technique and Timing
During the ACL surgery, the patient receives a tendon tissue graft to substitute the torn ligament. Since no one graft can be appropriate for each and every patient, multiple graft options are available. Depending on your condition, your doctor will recommend the graft suitable for you. They will consider your age, future goals, and lifestyle to determine the appropriate graft for you.
Timing of Surgery
Initially, it was suggested that delaying ACL surgery anywhere from 3-6 weeks after injury lessens the risk of developing arthrofibrosis in the joint. But now with new and advanced surgical techniques, surgery can be easily performed effectively within 3 weeks of injury with no difference in outcome. Also, delaying surgery beyond a certain point is reported to have negative outcomes like the chances of having a new meniscal tear.
Rehabilitation Duration and Adherence
A physical rehabilitation program is essential after ACL reconstruction. The rehab program is focused on restoring motion, enhancing neuromuscular coordination and balance, and improving muscle function. The goal is to help patients safely return to sports with a lower risk of a knee injury. While ACL reconstruction is generally effective, success largely depends on the commitment to rehabilitation, including strength, balance, and agility exercises. Patients who adhere to their rehab programs are reported to experience better outcomes than those who do not.
Psychological Consideration
It is common for the individual to have a fear of re-injury. This fear along with a lack of motivation and psychological readiness can prove to be as crucial as physical factors.
The following interventions can be effective for patients:
- Goal setting
- Positive self-talk
- Documentation of feelings
- Counselling
Phases of Recovery
In order to achieve the goal of recovery, therapy is typically broken down into stages (or phases) of activity, with goals for each stage. Here is an example of this phase protocol:
Phase 1 – Initial Recovery (Weeks 1-2)
During the first couple of weeks post-surgery, expect your knee to be swollen and stiff. Pain relief will likely be necessary, and your doctor will recommend the most suitable medication for you. It’s important to keep your leg elevated as much as possible, such as by placing pillows under your heel while lying down. You may receive a cuff to use at home to help reduce pain and swelling, so check with your surgeon or physiotherapist on the recommended usage. If you don’t have a cuff, using a towel-wrapped pack of frozen peas on your knee can be an effective alternative.
Phase 2 – Rehabilitation Phase (Weeks 2-6)
After the initial pain and swelling decrease, your physiotherapist may suggest modifications or enhancements to your exercise routine. These exercises aim to:
- Achieve full extension and bending of your knee
- Strengthen your leg muscles
- Enhance your balance
- Initiate proper walking
In about 2 to 3 weeks, you should be able to walk without the assistance of crutches. Alongside specific exercises, low-impact activities such as swimming and cycling may be encouraged for fitness.
Phase 3 – Strengthening Phase (Weeks 6-24)
You should gradually return to your usual activities within 6 weeks to 6 months following your knee surgery. Continuing low-impact activities like cycling and swimming are encouraged, but it’s important to avoid sports that involve twisting, jumping, or sudden movements, as the grafted tissue needs time to properly secure within your knee.
Phase 4 – After 6 Months
By the six-month mark, you might be able to resume playing sports. However, some individuals may require more time before feeling confident to return, and elite athletes might need an extended period to regain their peak performance levels.
Returning to Work
Your return to work will depend on the nature of your job. If you work in an office setting, you might be back in just 2 to 3 weeks. However, for those engaged in manual labor, it could take up to 3 months, depending on the physical demands of the job.
Long-term Recovery Considerations
As individuals progress through their rehabilitation journey, it’s essential to remain vigilant about potential complications and setbacks. Recovery can be unpredictable, and understanding what to look out for can significantly impact long-term success. Regularly check-ins with your doctor to identify any issues early on, ensuring a smoother recovery path.
Incorporate continued strength and conditioning exercises in your routine for long-term recovery. These exercises not only help in regaining muscle strength but also enhance joint stability and improve overall physical health. Staying active and gradually increasing the intensity of workouts will aid in maintaining fitness levels and fortifying the body against injuries in the future.
Moreover, long-term monitoring for joint health should be your top priority. Regular assessments can help track any changes and allow for timely interventions if problems arise. This vigilance can help prevent chronic pain and preserve mobility in the long run.
To Conclude
The recovery timeline involves various stages and requires a dedicated approach. Key points to remember include being aware of potential setbacks, the necessity of ongoing strength exercises, and the importance of monitoring joint health. Recovery is not a race; it’s crucial to practice patience and stick to rehabilitation plans diligently. With commitment and proper guidance, a successful return to optimal health and functionality is achievable.