Ligament Reconstruction
What Is Ligament Reconstruction?
Ligament reconstruction is a surgical procedure that can repair, tighten or replace a partially or completely torn ligament. A ligament is a fibrous, collagen-rich tissue that connects structures in the body. Ligaments are often found at the joints, where they connect bones with other bones. These ligaments provide stability, which helps to prevent the excessive movement or twisting that can lead to dislocation. When a ligament is damaged, usually due to extreme force, the joint can become unstable and limit movement.
When a ligament is stretched or torn, it’s known as a sprain. Most sprains will repair themselves with rest, ice, compression and elevation, along with medications that can reduce pain and inflammation. However, if patients experience repeated sprains or if the ligament is completely torn and won’t heal on its own, ligament reconstruction surgery may be necessary.
Almost any ligament can be reconstructed, but the most common are:
- Anterior cruciate ligament (ACL). During these procedures, the surgeon reconstructs the ligament that connects the thigh and the shin at the center of the knee.
- Posterior cruciate ligament (PCL). In PCL reconstruction, the surgeon reconstructs the ligament that connects the thigh and shin at the back of the knee.
- Lateral ankle ligament. Also known as a Brostrom procedure, a lateral ankle ligament secures or tightens the ligaments on the outside of the ankle.
- Carpometacarpal (CMC) ligament. Arthritis can affect the CMC joint, where the thumb and the trapezium bone meet in the wrist. During this surgery, the damaged ligament is removed and replaced with a graft from the flexor tendon in the wrist.
Before Ligament Reconstruction
If you’ve injured a ligament, you’ll need to stop putting weight on the area so it can rest and begin the healing process. Healthcare providers will also recommend ice, compression and elevation, along with medications. Physical therapy or rehabilitation may also help injuries when surgery isn’t deemed necessary.
If you and your provider decide that the location or the severity of the ligament damage warrants surgery, you’ll need to prepare by following all presurgical instructions, which may include discontinuing certain medications that can make your blood less likely to clot. Tell your doctor what medications you currently take, including any herbal supplements or vitamins, so the provider can determine if it’s safe to continue taking them.
During Ligament Reconstruction
During ligament surgery, you’ll be given anesthesia that will allow you to sleep and experience less pain during the procedure. Once you’re asleep, the surgeon will access the area — using minimally invasive techniques whenever possible — and repair or replace the ligament. A ligament replacement can be performed using an autograft (a ligament transferred from somewhere else in your own body) or an allograft (transferred from a donor or a cadaver).
After the surgery is complete, you’ll recover from the anesthesia in a post-anesthesia care unit or another room in the hospital. Depending on the surgery, some patients may be admitted to the hospital to begin the recovery process there. If your reconstruction was an outpatient procedure, you’ll stay in the hospital for a few hours before returning home.
After Ligament Reconstruction
After your ligament reconstruction, you’ll need to allow the area to rest, and you should refrain from activities that are not approved by your physician. You may require physical therapy, particularly if the reconstruction was to the knee, and you will have to wear a brace to keep the ligament stable as it recovers. Your physician will let you know when it’s safe to resume regular activities.