Today it seems a distant past, but during the time when I injured my ACL ligament, the whole process was nothing short of a nightmare. I am saying that not because of the pain, procedure, or rehabilitation efforts but due to the lack of crucial information on the topic. The only one I wanted to trust at that time was someone who had gone through the procedure, but I found only distorted information on the internet.
Thus, I am sharing what I experienced, (problems, hidden steps, cost barriers, etc.) with the intention to help the next me searching online for information. Please give us your feedback if you find the information useful, or if not, please suggest what else you need to know, and I will reach back to you.
Let’s Start With…
What Is ACL (Anterior Cruciate Ligament) Tear?
The anterior cruciate ligament is positioned under our knee to support and balance our movement. Breaking of this ligament is known as an ACL tear. There are 4 types of ligaments present under our knees, but ACL ligaments are most vulnerable to sports injury.
If you play football, kabaddi, hockey, or any other game with extensive use of foot stop and go mumover. It’s likely that your ACL is torn if your knee is swollen for days. So this brings us to how we detect if your ACL is broken or not.
How to Detect if an ACL is Torn?
4 Major ACL Tear Detection Parameters
Firstly, everyone says it’s painful, but from my personal experience, it might not hurt that much. So, what are the tried and tested ways to detect if your ACL is torn or not?
- You would hear a TICK sound internally (no one else would hear it, just you) as a tight thread snapped when and if your ACL tears.
- Your knee will swell up like a balloon and will remain such.
- You will feel a disconnect during the Lachman test.
- Knee MRI for final confirmation.
First, if you hear a TICK sound and feel injured, go home. Rest for a while and see if your knee is highly swollen or not compared to your other knee. If it is, start icing your knee, don’t put a hot towel on it (a common mistake). Don’t move much, as it can worsen your state. Now next day visit a doctor for a check-up. The doctor will, most likely, perform the Lachman test for confirmation. Go for an MRI is suggested by the Doctor.
Now you will have the confirmation. ACL is a costly procedure (compared to an injury by sports) but don’t blame yourself for it. It can happen to anyone. Prepare yourself physically and mentally to dedicate yourself to healing your leg.
ACL Tear Stages
Sorry, I forgot to mention that ACL has 3 stages. They go like this:-
Grade 1 – The ligament gets loosened
Grade 2 – The ligament gets a small tear
Grade 3 – Complete ligament tear
The first two grades can be somewhat healed on their own or with rehabilitation but complete tears require a small surgical treatment.
Finding yourself an Experienced Doctor.
If you are someone like me who has to go through a surgical process, you must find yourself an experienced doctor. Many people compromise with experience over cost which may not be a good idea. The expertise of a qualified surgeon will decide how comfortably you will walk the rest of your life.
But costlier does not always mean better. So to find a proficient doctor:-
- Ask how many ACL surgeries he/she has conducted.
- See if he is confident about it. (Ask if you would be able to walk normally afterward or not)
- Find a qualified orthopedist at an established hospital with a proven track record.
For North Indians Forties Mohali is considered the best place for an ACL reconstruction surgery (I didn’t go there). But that’s not the only option, VMMC Safdarjung Hospital, etc. are also some notable options.
Types of ACL Reconstruction.
Orthopedists repair ACL tears using two types of grafts, Allografts and Autografts. Grafts are the artificial or natural replacement of ligament that is used to reconstruct your tear.
Allograft
Artificially synthesized graft that imitates the flexibility and strength of your natural ligament.
Pros
- Easy to Operate with
- Short surgery process
- Quick rehabilitation and recovery
Cons
- It gets weak with time
- Always a risk of a break
- Loose or tight grafts will require another surgery to fix.
Autograft
The graft is taken from the host itself* or a doner to reconstruct the ACL with natural ligament.
* Our body has extra ligaments in our legs that orthopedists can use to create a natural graft.
Pros
- Autograft becomes part of our body
- It grows strong with time and exercise
Cons
- Takes longer during rehabilitation
- Longer operation time
- May leave some occasional minor pain
Autograft is the more adopted path by patients. I took it as well and now after 6 months, I am playing football, my dearest game, again.
ACL Reconstruction Surgery Actual Cost?
ACL reconstruction cost in 2023 Bharat (India) ranges from 25k-3lac or above. It will cost you around 25-40k to have an ACL reconstruction surgery in your city’s government hospital with Allograft. The cost of Autograft surgery can be over 50k.
From a premium hospital, you can expect a surgical cost of 2-3 lacs. The difference will be in expertise, care, luxury, rehabilitation(very important), and percentage of success.
Well-known government hospitals such as PGI, VMMC, and others will also share the same level of expertise and percentage of success but may lag in care and rehabilitation facilities.
Post Surgery Timeline…
Okay now that you have decided on your surgical destination and operator let’s move on to the post-surgery process.
Immediately After Surgery
You will not feel anything below your waistline because of the backbone anesthesia. But the numbness will go away eventually after a day or two. It is advised to not lift your head for at least a day to avoid headaches.
Immediately after surgery, the doctors will keep you under observation in the emergency room. If you don’t feel any pain during that time then the surgery went well.
A few Hours After Surgery
Now it’s time to take a deep breath and try to sleep. Avoid all and any motion for a day during this time. You are also not allowed to eat or even drink water before and a few hours after surgery. Also, the medicine will start with a glucose drip at this time.
A day has passed
This will begin to feel alright now. Rehabilitation will also begin immediately. It will include standing up (with a walking stand) and moving a few steps if possible. If all went well you will be out of the hospital in less than 3 days.
