Patient Information

Please bring identification, insurance details, and any previous medical reports related to your knee condition.

This depends on the procedure and recovery speed, but typically 4-6 weeks once you can bear weight comfortably and perform an emergency stop.

Yes, post-surgical physiotherapy is vital for optimal recovery, helping regain strength, mobility, and function.

Following knee surgery, the recommended time off work varies by procedure and job demands:

• ACL Reconstruction : 2-4 weeks off for desk jobs; up to 12 weeks for physically demanding jobs.
• Meniscal Repair : 2 weeks for desk jobs; 8 weeks for active jobs.
• Multi-Ligament & PCL Reconstruction : 8 weeks for office work; 16 weeks for physically demanding jobs
• Knee Arthroscopy : 2 weeks off for desk jobs; up to 6 weeks for heavy work.

ACL reconstruction surgery carries certain general risks, including:

• Infection:
  The risk of infection is approximately 1 in 400. This can occur despite the use of sterile surgical techniques, pre-operative intravenous antibiotics, and antibiotic treatment of graft tissue. If the infection is superficial, it may be treated with a course of antibiotics. However, if the infection affects the knee joint itself, further surgery to clean the joint and intravenous antibiotics may be required. In rare cases, if the infection persists, the graft tissue may need to be removed.
• Deep vein thrombosis (DVT) and pulmonary embolism (PE):
  Blood clots can form in the deep veins of the leg, which may dislodge and obstruct the arteries in the lungs. DVT presents as leg pain and swelling after surgery and is diagnosed via ultrasound. Treatment with blood thinners may be required, depending on the type of DVT.
• Bleeding and haematoma formation:
  Small blood vessels at the surgical site may continue to bleed after surgery, causing swelling, bruising, and pain. While this typically resolves on its own, some cases may require surgical intervention to remove the pooled blood.

Specific risks associated with ACL reconstruction surgery include:

• Saphenous nerve damage:
  Damage to this nerve can occur during hamstring harvesting, resulting in a numb area on the inside of the leg. This typically improves over time but may be permanent in some cases. Importantly, this does not affect the function of the ACL graft.
• Difficulty kneeling:
  Harvesting of the patella tendon involves an incision over the front of the knee. Due to the location of the graft, some patients may experience discomfort when kneeling.
• Patella fracture:
  Harvesting the patella tendon with a segment of the patella bone may weaken the patella, increasing the risk of fracture. Should this occur, surgical repair is typically required.
• Graft re-rupture:
  Despite successful rehabilitation, an ACL graft may fail. The risk is highest within the first year post-surgery and remains elevated during the second year, especially in younger patients. If graft failure occurs, revision surgery may be considered.
• Stiffness:
  Post-surgery, the knee may become stiff due to scar tissue formation. This is usually resolved through physiotherapy, but in some cases, manipulation under anaesthesia may be necessary to improve movement.
• Long-term osteoarthritis: Despite successful ACL reconstruction, there remains an increased risk of developing osteoarthritis in the long term due to irreversible cartilage damage sustained during the initial injury.

ACL tears typically result from placing the knee in a compromised position that it cannot withstand, such as during rotational movements. Muscle fatigue and poor biomechanics are common contributing factors. The knee must partially dislocate for an ACL tear to occur. Some individuals are more prone to ACL tears due to anatomical variations that place additional stress on the ligament.

While the tissue used for reconstruction is biomechanically stronger than the original ACL, there remains a risk of reinjury. It is crucial to adhere to the post-operative instructions provided by the Yorkshire Sports Knee Clinic and your physiotherapist to minimise this risk, which is highest within the first 12 months and remains slightly elevated during the 12-24 month period. Prior to returning to sports, it is essential to ensure symmetrical muscle bulk with good knee control, as demonstrated by single-leg squats, hops, and other exercises. Return-to-play testing with a physiotherapist will be arranged at the appropriate time.

Patients who suffer an ACL injury often have intrinsic factors that predispose them to ligament injuries, making them more susceptible to ACL tears in the other knee.

Incorporating specific exercises into your warm-up routine before playing sports has been shown to reduce the risk of ACL injuries. Key components of these exercises include:

• Core training: Strengthening the hip and trunk muscles
• Neuromuscular control and balance: Focusing on proper jump and landing techniques
• Plyometrics and agility: Developing explosive power and coordination
• Strength training: Targeting the quadriceps and hamstrings

The decision to undergo ACL reconstruction depends on your level of activity and expectations. In lower-demand patients not engaged in sports requiring rapid direction changes, a 4-month course of physiotherapy to strengthen the surrounding muscles may provide adequate stability.
For younger athletes involved in high-demand sports, ACL reconstruction is often recommended to restore joint stability, particularly when a repairable meniscal tear is also present. Surgical reconstruction helps prevent further meniscal damage and early onset arthritis.

There is no strict age limit for ACL reconstruction. The decision to proceed with surgery is based on various factors, including symptoms, duration of the injury, and the presence of cartilage damage or arthritis. If you are uncertain, the Yorkshire Sports Knee Clinic can provide guidance on the best treatment approach for your knee.

Lateral tenodesis is a procedure that involves rerouting a strip of tissue from the iliotibial band under the lateral collateral ligament. It provides additional rotational stability and is performed alongside ACL reconstruction in selected patients to reduce the risk of reinjury.

Yes, preserving and repairing the meniscus is always preferred, as it cushions and supports the cartilage. If a meniscal tear is present alongside an ACL injury, it will typically be repaired during ACL reconstruction. A meniscal repair may slow rehabilitation initially but offers better long-term outcomes by promoting tissue healing through the blood-rich environment created by ACL surgery.

You will be able to walk and bear weight with crutches on the day of surgery. Crutches are generally required for 1-2 weeks for comfort. A post-operative brace is not typically needed unless a meniscal repair was performed, in which case you may require a brace and limited weight-bearing for up to six weeks.

Driving is not recommended for six weeks following ACL reconstruction. Before resuming driving, you should no longer require strong painkillers, be walking unaided, and have a near-pain-free range of motion in the affected knee.

The surgical wound must be kept dry for two weeks post-operation. Following review at your two-week consultation, you can begin showering without dressings. Swimming or pool-based rehabilitation is not advised for four weeks post-surgery, as it may increase the risk of infection.

Several factors determine when you can return to competitive sports following ACL reconstruction. It is essential to ensure that the graft has adequately healed and that muscle strength and control have returned to near-normal levels. This is typically achieved at least 12 months post-surgery.

Post-Surgery Guidelines: Tailored rehabilitation protocols emphasizing safe recovery and return to daily activities. See rehab protocol page..
At Yorkshire Sports Knee Clinic, we ensure that every patient has a tailored rehabilitation plan, optimized for their specific surgery and recovery goals. From pre-operative education to detailed post-surgery care, our multidisciplinary team is here to support you at every stage. For specific rehabilitation protocols, consult your physiotherapist and surgeon for personalized care recommendations.