Can You Have an Acl Tear and Not Know It

1 of the most common knee injuries is an ACL tear. In this post, I will address the most important things you lot need to know about ACL tears and your handling options in Singapore.

Equally an experienced Orthopaedic sports surgeon, I've treated all types of athletes. The young and old, earth grade to weekend warrior, with ACL injuries.

I've distilled my cognition and I want to help y'all make an informed decision regarding the management of an ACL injury.

What is an ACL tear?

ACL stands for Anterior Cruciate Ligament. I often describe ligaments as a rope like structure.

The ACL is i of the primary ligaments in the knee. Information technology sits in the middle of the genu and attaches the thigh bone (femur) to the shin bone (tibia). The fundamental function the ACL is to finish the shin bone from sliding forrad and rotating excessively.

So if your ACL is torn, your knee has a high chance of giving mode during movements that require a sudden change in management. Some of these movements include, sidestepping, or pivoting. These may happen during a game of basketball, rugby, and even martial arts.

How can you tell if your ACL is torn?

If yous take an ACL tear, it would have probably occurred while you were turning on your knee during sports. Yous volition most likely feel a 'pop' sensation and realise that your genu is swollen. This is due to the bleeding of the torn ligament.

Remember Michael Owen's sickening injury during the 2006 World Cup?

A key symptom is that y'all are immediately unable to walk or proceed playing due to hurting. After the swelling in your knee subsides, your articulatio genus may feel unstable or fifty-fifty give way. You lot're virtually likely unable to play your favourite sports.

When I examine your human knee, I'll use a series of tests to examine stability and ACL function. I'll and then order an MRI scan to confirm whether y'all accept an ACL tear and any other knee joint injuries.

Which famous athletes take had an ACL tear?

**
**

Examples of famous athletes who have suffered an ACL tear include:

• Zlatan Ibrahimović- Swedish professional footballer
• Ruud Van Nistelrooy - Dutch footballer (retired)
• Paul Gascoigne (Gazza) - English former professional football game player & director
• Alan Shearer - English footballer (retired)
• Tom Brady - American football game quarterback
• Tiger Woods - American professional golfer
• Jamal Crawford - American professional person basketball player
• Derrick Rose -American professional basketball game player

So if you have an ACL tear, you're actually in first-class company.

Here'south the good news: all these athletes from different sporting backgrounds were able to resume their playing careers successfully afterward an ACL reconstruction.

Tin a torn ACL heal on its own?

Unfortunately, the ACL usually does not heal well on its own. I liken it to a rope.

If a rope is completely torn in the centre, information technology is very difficult for the rope ends to come together for a long plenty fourth dimension to heal. Reason beingness, your genu is moving all the time.

In the event that you have a partial ACL tear, or play sports that do not involve sudden turning movements, you may exist able to return to sports without surgery.

Is ACL reconstruction surgery the only treatment option for an ACL tear?

ACL reconstruction is when the torn ligament is completely replaced by a "graft" (it's a replacement tissue). This is to provide stability to the knee. For athletes who are unable to play sports following an ACL tear, this is the recommended handling option.

I'd unremarkably recommend a good physiotherapist to help you undergo rehab earlier because surgery. This allows your genu to regain full range of movement and strength.

In my practise, I likewise offer a treatment called ACL repair. For this method, the ends of the torn ACL are reattached to the thigh bone using a device chosen an internal caryatid. Not all ACL tears are suitable for this method of treatment.

In that location're many studies on the use of stem cell and platelet rich plasma in ACL healing. Still, these technologies are still experimental.

Many still consider the "aureate standard" (best) treatment to be ACL reconstruction surgery.

How much does an ACL surgery cost in Singapore?

Total operation fee: ACL Reconstruction

Where

Cost

Public Hospitals (Subsidised)

$502 - $i,200

Private Hospitals

$17,000 - $21,000

In government hospitals, you can use subsidies of up to effectually $3,950 for the surgery. An ACL reconstruction costs around $i,000 later subsidy.

In individual hospitals, ACL reconstruction costs between $17,000 - $21,000. In certain individual hospitals, if y'all have an Integrated Shield Plan and a total passenger, you may be eligible for cashless treatment, with no payment needed at admission or belch.

Factors that touch its price: class of bed, length of stay, cost of materials, and implants.

Breakup of cost for ACL reconstruction surgery at private hospitals

Service

Cost

Surgeon Fees

$eight,560 - $13,000

Anaesthetist Fees

$i,605 - $2,100

Facility Fees

$4,300 - $6,800

The cost of an ACL reconstruction at public hospitals is definitely cheaper. However, you may have to wait several months for your surgery. For private hospitals, you may be able to have your functioning within the week.

A not-specialist may be involved in a big part of your surgery in the public sector, unless you lot pay extra to be upgraded to individual specialist-only care. In subsidized B2/C grade wards in that location is no air-con and each cubicle tin can have 6-8 beds.

The choice between public and private is a very personal one. The experience between the ii tin vary significantly.

Who volition benefit most from an ACL reconstruction surgery?

In a nutshell, anybody with an unstable human knee that stops them from playing sports or working!

From my feel, I find that these types of patients will do good the most:

• Active developed patients involved in sports requiring pivoting or turning. For example: soccer, rugby, basketball game, etc

• Agile adult patients with jobs, particularly heavy labour, requiring pivoting or turning

• Older patients (e.g. above l) who are notwithstanding playing sports and don't have degenerative change in their knees

• Children or adolescents with ACL tears - a modified technique tin be used to reduce risk of injury to the growth plate.

• Athletes with other injuries to their knees as well as ACL tear. East.thou. ligaments such as the PCL (posterior cruciate ligament), LCL (lateral collateral ligament), menisci, and cartilage.

• Particularly for meniscus tears, a amend upshot tin be had if the repair is washed at the same time as an ACL reconstruction

When is the all-time time to go for an ACL reconstruction surgery after an injury?

From my feel, going for an ACL reconstruction surgery inside a few weeks of injury is virtually platonic. Delaying surgery for more than than half dozen months is associated with a college risk of injury to other structures in the genu like cartilage and menisci.

What happens during an ACL reconstruction surgery?

The whole procedure takes virtually an 60 minutes to complete.

Timeline of what happens during a typical ACL reconstruction surgery:

• You will have an anaesthetic and get to sleep during surgery.

• I make two small keyhole incisions at the front of the knee. Then I make some other pocket-size one on the inside to harvest your hamstrings to replace your ACL. This procedure is minimally invasive.

• Then, I inspect the knee thoroughly with a telescope, and drill small tunnels in the thigh os and shin bone where the ACL sits.

• The placement of these tunnels is important to achieve a practiced result.

• I'll and then pass the hamstring graft through the tunnels and secure it with a metal button and plastic screw.

• You lot'll be able to walk the aforementioned day after surgery with crutches.

• In the UK and Australia where I trained, most patients can go abode on the same mean solar day of surgery.

Who tin can perform an ACL reconstruction surgery in Singapore?

Whatever Orthopaedic surgeon who is accredited by their hospital may perform ACL surgery. This may depend upon their training and number of cases performed. However, you may prefer to have your ACL reconstruction performed by a defended Sports Surgeon.

What are the advantages and disadvantages of going for ACL reconstruction surgery?

Advantages:

1. Stable knee
2. Able to return to sports and activities you relish
3. Possible reduced run a risk of early arthritis (on Xray)
4. Better event if other damaged structures such as menisci are repaired at the same time

Disadvantages:

1. Long recovery period (run across below) and rehabilitation
2. Risks and cost of surgery

How much improvement can yous expect subsequently an ACL reconstruction surgery?

Every bit I say to my patients, having an ACL reconstruction doesn't turn you into Cristiano Ronaldo. Even so, it gives you an excellent take chances of getting back onto the football game field again.

In one study involving 122 athletes, over 90% were able to return to sport post-obit ACL reconstruction.

What is the recovery process and downtime similar after an ACL reconstruction surgery?

• After the surgery, you'll be given some strong painkillers to minimise the pain.

• Y'all'll be able to get up and walk right later the surgery, with crutches

• Some patients are well enough to go habitation the same twenty-four hour period

• It'south important to get-go physiotherapy soon after the operation, and continue for half dozen-9 months

• You may be on crutches for upwardly to 6 weeks

• You can showtime driving once more at 4-6 weeks

• You can render to office-based work after 2 weeks

However, if y'all have a physically demanding job, it volition take you lot longer to return to work.

As for sports, it can be anything from 6 - 12 months. Well-nigh of the times, people are able to become back to playing during the 9th month.

Bear in heed that, some people are able to recover quickly, some take a little longer.

Zlatan Ibrahimovic was back playing for Manchester United 7 months after his ACL tear in 2017. However, anybody is unlike.

If yous render to sport too shortly, you have an increased take chances of your ACL graft re-tearing. It'south important to follow your physiotherapist'due south instructions advisedly.

How to get the best results after an ACL reconstruction surgery?

Firstly, find a surgeon that you feel comfortable with. I frequently advise my patients that it'due south best not to delay surgery more than six months post-obit injury.

Next, I will always recommend a practiced physiotherapist who will take you through the lengthy rehabilitation procedure and help you get the best result.

Then, I typically arrange physiotherapy for you before surgery to regain total range of move, decrease swelling, and increase leg strength.

Information technology'southward best to become moving as presently every bit possible later on surgery (every bit pain allows). In the infirmary, your physiotherapist should be working on getting your genu straight, reducing swelling, and getting your quadriceps muscles (front of thigh muscles) working again.

Knee CPM device, rehabilitation after surgery

Once you are discharged from hospital, you lot should begin physiotherapy as presently equally possible. Over the adjacent 6-12 months you should undergo a rehab program that volition initially help you regain your leg balance, force and agility. Y'all'll and then progress onto running and pivoting, and finally return to sport.

Important note: Don't exist a hero and become dorsum to sport besides difficult and also soon! Especially more than and so if you're involved in a sport with a lot of pivoting movements like basketball or rugby.

Ease yourself in gradually. Call back, information technology will take time to rebuild fettle and skill levels.

Last but not least, always warm upward and cool downwards properly. Fix aside extra time to keep working on the exercises your physio gave you.

You should too participate in a neuromuscular training program (such as the Fifa 11+ or PEP program) to reduce to chance of reinjury, or ACL tear in the other knee.

Folio one of the Fifa 11+ programm

11+ is a complete warm-upwards program to reduce injuries among male and female person football players

Volition y'all notwithstanding feel pain afterwards the ACL reconstruction surgery?

From my experience, I ordinarily prescribe strong painkillers to minimise hurting following the surgery. Most people stop taking the painkillers after a calendar week or so. Y'all should no longer experience the pain and shock associated with your human knee giving fashion.

What are the complications following ACL reconstruction?

Yous are usually young and medically fit if you lot undergo ACL reconstruction. Risks are typically depression post-obit surgery. These may include:

1. Temporary pain, swelling, and stiffness – this improves with painkillers and physiotherapy over fourth dimension.
2. Infection – around 0.37% risk of infection. You're given antibiotics at the time of surgery, and pocket-size incisions / keyhole surgery are used to minimise adventure of infection.
3. ACL graft re-tear – effectually half-dozen% of patients may feel graft re-tear at five years. The ACL reconstruction is very strong, simply may re-tear if yous accept a repeat injury to your knee. Post-obit your physiotherapist's instructions and not returning to sports too early may reduce the risk of re-trigger-happy.

Am I able to proceed doing sports after an ACL reconstruction surgery?

The vast bulk of athletes can return to sports. Almost render to their pre-injury level of sport.

How can you find the all-time orthopaedic surgeon in Singapore for ACL reconstruction?

Personally, I call up the best surgeon for you is one who is skilled, listens, and cares. Ideally, they will exist active in sports themselves, and understand the mechanics and demands of your favourite sport.

For me, I've played rugby and athletics to a loftier level at schoolhouse and Academy. Currently, I compete in Brazilian Jiu Jitsu in tournaments across Asia. I also bask Muay Thai, golf, cycling, and skiing.

I love sports! Which is why I am able to empathize the thought process of a sports person and their concerns very well.

What questions about my ACL treatment should I ask my doctor?

• Are you lot a defended sports surgeon?

• Do you play sports yourself and do you understand my sport?

• What is your favourite graft pick and why?

• What technique do y'all utilise (e.g. transtibial vs medial portal) and why?

• What are the risks of ACL reconstruction?

• What sort of rehabilitation programme does your physiotherapist use and why?

• When will I be able to go back to work?

• When can I play sports once again?

The ACL is of import for knee joint stability in sports requiring sudden turning motions.

An ACL tear used to be a career catastrophe injury, merely at present the bulk of professional athletes are able to continue their careers following reconstruction, with the correct surgical techniques and rehab.

If you lot love sport but your human knee keeps giving style, then ACL reconstruction may exist the platonic solution for you lot. I hope this article helps you lot in your decision-making process, practiced luck!

---

Dr Alan Cheung is a Consultant Orthopaedic Surgeon in Singapore specialising in Sports Injuries and Adult Reconstruction. He too performs Robotic Surgery, and manages General Developed and Paediatric Trauma, and Musculoskeletal Tumours. He aims to perform surgery services through minimally invasive incisions to reduce pain, blood loss and scarring and let a faster recovery.

thorntonsqualf39.blogspot.com

Source: https://www.human.com.sg/guide-to-acl-tears-in-singapore

Bagikan Artikel ini