Reconstruction of ACL by arthroscopy

Reconstruction of ACL by arthroscopy

Arthroscopy is an advanced alternative to “open” knee surgery, reducing recovery time and scarring. This form of minimally invasive surgery begins with the orthopaedic surgeon making two small, almost unnoticeable, incisions around the knee to correct the problem. One hole is used for a small fibre optic telescope to examine the knee via video monitor and the other hole for the instruments to perform the surgery.
What is the structure of the knee?

The major structures of the knee include bones (femur, tibia, and patella), cartilage, muscles (quadriceps, hamstrings) as well as tendons and ligaments.

Ligaments are strong, elastic bands of tissue that connect bone to bone. They provide strength and stability to the joint. The collateral ligaments (medial collateral ligament (MCL) and the lateral collateral ligament (LCL) prevent the knee from coming apart at the sides whereas the cruciate ligaments (anterior cruciate ligament (ACL) in the front of the knee and posterior cruciate ligament (PCL, at the back) prevent the knee from gliding forward and backwards. These ligaments can stretch and tear leading to complications requiring surgery.

The meniscus is a c-shaped pad between the femur (thigh bone) and tibia (lower leg bone). It acts as a shock absorber and makes the motion of the knee smooth. The meniscus may be damaged by twisting movements that force the knee beyond its normal range of motion which can occur during strenuous physical activity like basketball, football, tennis, skiing and jogging, or be a result of arthritic degenerative changes. As the meniscus has a limited blood supply, it is unable to undergo a normal healing process when damaged which may result in torn pieces getting jammed inside the joint. When this occurs, the knee becomes painful, swollen and difficult to move.
What exercises are good for strengthening leg muscles?

Two effective exercises can be performed at home to strengthen leg muscles:

Quadricep setting:

  • Lie on your back with your knees straight, legs flat and arms by your side
  • Tighten the muscles on the top of the thigh (quadriceps) and, at the same time, push the backs of the knees down onto the floor and raise only the heels
  • Hold for five seconds, relax for five seconds. Repeat the exercise six times
  • Perform the quadricep setting at least four times a day

Straight leg raising:

  • Lie on your back with your operated knee flat and straight
  • Keep the other leg on the floor
  • Slowly raise the operated leg about six inches off the floor, keeping the leg as straight as you can.
  • Hold for five seconds, then lower the leg
  • Repeat the exercise six times
  • Perform the straight leg raising at least four times a day
Will a torn ligament heal itself?
The ligaments outside the knee joints such as the medial and collateral ligaments can heal after periods of protected rest. In some cases, the thigh muscles are able to take over the function of the torn ligament following sufficient muscle strengthening. However, a serious tear of the ACL can never heal without proper treatment. The knee may become unstable and repeatedly “buckle” or “give out”, if not treated.
What treatments can be undertaken with arthroscopy?

Arthroscopy is typically used for reconstruction of the ACL,  a very common injury for athletes. This treatment is also offered for menisci tears (meniscectomy).

For more information, please refer to orthopaedic treatments.

What are the advantages of arthroscopy compared to traditional "open" surgery?
  • less trauma to muscles, ligaments and tissues
  • smaller incisions with less scarring
  • faster healing process
How do I know my knee needs surgery?
The knee can be injured from twisting movements that force the knee beyond its normal range of motion. You should suspect significant injury to your knee joint, and seek a professional opinion, if you hear a “pop” followed by pain, swelling or limited movement.
How will surgery be performed?
How will surgery be performed?

The surgeon will insert the arthroscope into the joint through a small incision less than one centimetre in diameter. The arthroscope carries fibre optic lights and is attached to a video camera, which feeds a video monitor. The surgeon will pass instruments through another incision to perform surgery to repair the damaged anterior cruciate tendon. Most of the time, the surgeon uses a part of your own patella tendon.

Following surgery, a bulky dressing is placed around the joint and stays on for one to two days at which time a new bandage will be applied.
What kind of anaesthesia will be needed?
Spinal or general anaesthesia.
How long will surgery take?
ACL reconstruction takes about two hours in healthy patients with no further complications.
Will I feel pain afterwards?
Following the operation, you will stay in bed for another six hours to allow the anaesthesia to wear off and then be encouraged to sit up or slowly walk around. Pain or discomfort is normal following arthroscopy, treated by pain-killing injection or drainage of body fluids and excess blood from the joint area.
How long is recovery?

Six nights in hospital are usually required when you will be carefully monitored and cared for. You will work with a physiotherapist to strengthen your leg muscles and stabilise your joints. Prolonged walking should be avoided after surgery to prevent joint swelling and walking aids (crutches) may be prescribed.

Two weeks is required for recovery. Your surgeon will review your situation following the two week period to assess your recovery and usually, you will have to wait about three weeks before flying ( this has to be discussed with your doctor since it differs case by case).

  • It is important that you take the pain medication prescribed as it reduces swelling and pain in your knee. The pain will subside gradually each day.
  • Crutches are needed for a few weeks after surgery, the exact time depending on your recovery and your surgeon and physiotherapist. Put only as much weight on your operated leg as your doctor or therapist advises.
  • A detailed rehabilitation programme will be explained to you by our physical therapist, including performing daily knee exercises to recover the range of motion and strengthen weakened muscles.
  • Keep your wound and bandage clean and dry. The wound should not come into contact with water. Do not remove the dressing unless instructed by your doctor.
  • You may sit on a chair to take a shower. Use a plastic bag to protect your wound from water.

You will be given a follow-up appointment to see your FVH surgeon. It is important that you keep to the appointment. If you are unable to do this, please call the FVH Orthopaedic Department to obtain a new appointment date.

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Reconstruction of ACL by Arthroscopy

Reconstruction of ACL by arthroscopy & Leisure Combo

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Ear & Leisure Combo Package

Are you searching for a safe, reliable and high-quality destination for your surgery or medical treatment but at the same time want to enjoy the beauty and uniqueness of a travel hotspot? Look no further! We have the most suitable packages for you right here in Vietnam!

We can offer you the most professional surgery/ treatment + relaxing leisure combo programs, in conjunction with Buffalo Tours, a leading and award-wining tour operator in Vietnam. Packages can also be tailor-made to your own special desires.

Please note that all of our packages & prices are estimates only and that durations can vary, depending on the timing of your admission, your surgery/treatment and your condition to fly back home. In some cases your doctor might restrict you from certain activities and the below package might not be suitable for you.

Below follows an example of a package:

  • Day 01
    Arrival, welcome and airport pick-up by Buffalo Tours Representative. Transfer to Renaissance Riverside Hotel 5* (www.renaissance-saigon.com) for check-in and rest.

    Overnight at Renaissance.
  • Day 02
    Transfer to FV Hospital for first consultation(s)/tests.
    After first consultation(s)/tests, transfer back to Renaissance, stay overnight.
  • Day 03–09
    Transfer to FV Hospital for Hospitalisation and Surgery.
  • Day 09–31
    Transfer from FV Hospital to Thao Dien Village (www.thaodienvillage.com)

    Relax and enjoy the natural setting and tranquil atmosphere of the Thao Dien riverside complex. Choose from delicious European, Vietnamese, Thai and Japanese cuisine at the complex’s four restaurants.

    FV hospital for post-discharge consultation (after recommended of days from doctor)

 

  • Day 32
    Transfer to airport for flight back home.
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Reconstruction of ACL by Arthroscopy

  • Reconstruction of ACL by arthroscopy (Kenneth Jones procedure): US$4,000

Note: This package includes a MRI scan, however if you bring a recent MRI that is deemed medically satisfactory we will not repeat this examination and the price of the package will be reduced with US$330. 

The package includes:

  • Pre-operative consultations and tests
  • Hospitalisation
  • Surgical procedure
  • Doctor fees
  • Regular treatment and tests during hospitalisation
  • Physiotherapy
  • Discharge treatment
  • Follow-up consultation
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