ACL Reconstruction Surgery in Singapore

What Is ACL Reconstruction Surgery?

Anterior cruciate ligament (ACL) reconstruction is a surgical procedure that replaces a torn ACL in the knee. The ACL is a ligament that stabilises the knee joint. ACL tears are a common knee injury, particularly among athletes. Symptoms of a torn ACL may include knee instability and difficulty with activities like walking, running, or jumping.

The cost of ACL reconstruction surgery in Singapore depends on several factors, including the doctor's fee, hospital charges (public vs private), the specific type of surgery, anaesthesia, and insurance coverage. Fortunately, this procedure is insurance- and Medisave-claimable in Singapore. For more precise cost estimates tailored to your specific circumstances, please contact us at 8028 4572.

What Is the Difference Between ACL Reconstruction and ACL Repair?

ACL reconstruction and repair are two surgical options for treating a torn ACL in the knee, but they differ in their approach.

ACL Reconstruction replaces the torn ACL with a healthy tendon graft, typically from your hamstring or kneecap. Reconstruction is generally recommended for complete tears or when the torn ACL cannot heal properly on its own. It offers better long-term stability, especially for active individuals.

ACL Repair attempts to mend the torn ends of your original ACL back together. It is less invasive than reconstruction but is generally only suitable for very specific tear patterns, often partial tears where the ligament remains mostly intact.

Who Should Consider ACL Reconstruction Surgery?

ACL reconstruction surgery is generally recommended for individuals with a torn ACL and who experience persistent knee pain and instability, particularly:

Complete ACL Tears – When the ACL is completely ruptured, it cannot heal on its own and therefore requires a healthy graft to retain function.

High Physical Demands – Individuals involved in sports or jobs that require pivoting, sharp turns, or activities that put significant stress on the knee (e.g., jumping, landing) are strongly encouraged to consider ACL reconstruction surgery for better long-term stability.

Combined Injuries – ACL tears often coexist with damage to other knee structures like the meniscus, cartilage, or ligaments. In these cases, surgery is often the recommended course of treatment to address these issues.

ACL reconstruction surgery offers a path towards healing and a strong, stable knee.

Contact our orthopaedic clinic at 8028 4572 to begin your ACL recovery journey today.

What Are the Types of ACL Reconstruction Surgery?

Choosing the right graft depends on various factors, including your age, activity level, knee anatomy, and ACL surgeon preference. The most common graft options include:

Patellar Tendon Graft
The surgeon removes the midsection of your kneecap tendon and takes out bone plugs from your kneecap and shinbone. These plugs act as anchors after the graft (tendon) is inserted through a drilled tunnel in your leg bone. Over time, the plugs fuse for a strong, stable ACL replacement.
Hamstring Tendon Graft
The surgeon uses one or two tendons from your hamstring muscles in the back of your thigh. Unlike patellar tendon graft which uses bone plugs, this uses screws to hold the graft in place. Hamstring grafts strengthen over time as they fuse with the bone.
Quadriceps Tendon Autograft
This graft uses a portion of the tendon connecting your quadriceps muscle to your kneecap. Surgeons may consider this option for revision surgeries (repeat ACL reconstruction) where other grafts are not suitable.
Allografts
These grafts come from donated tissue from a deceased donor. They offer an alternative for patients who may not want to use their own tendons or have concerns about weakening surrounding tissues.

How to Prepare for ACL Reconstruction Surgery?

Undergoing ACL reconstruction surgery involves several steps to ensure a smooth procedure and optimal recovery. Here is a breakdown of what to expect:

Pre-operative Assessment

Physical Assessment – To prepare for surgery, your doctor will check how well your knee can bend and straighten and how strong your leg muscles are.
Imaging Tests – X-rays and MRI scans will be performed to evaluate the extent of your ACL tear and assess the surrounding knee structures.
Medication Review - Inform your doctor about all medications you take, including over-the-counter drugs and supplements. Certain medications may need to be adjusted or stopped before surgery.

Prehabilitation

Preoperative physiotherapy will be recommended several weeks before the procedure. This programme is designed to:

Improve surgical outcomes
Restore the normal range of motion in the knee
Strengthen the muscles around the knee
Reduce swelling and stiffness

Pre-surgical Instructions

Patients will also be given specific instructions to follow in the days leading up to the surgery, including:

Fasting – You will be instructed to avoid eating or drinking for several hours before surgery. This ensures an empty stomach, minimising the risk of complications during anaesthesia.
Rest and Sleep – Getting adequate quality sleep promotes healing and reduces stress on the body, allowing you to better tolerate surgery and recover faster.
Smoking Cessation – Avoid smoking one week before surgery. Smoking makes it difficult for you to clear your secretions after surgery and may impede your recovery.
Preparations for Home Recovery – Arrange for transportation after surgery and consider having assistance from family or friends for daily activities in the initial recovery period. You may also need walking aids like crutches.

What Happens During ACL Reconstruction Surgery?

ACL reconstruction surgery repairs a torn ACL through a minimally invasive approach called arthroscopy. During the procedure, patients are given anaesthesia for comfort.

First, the surgeon makes small incisions to insert a camera and tools to perform the procedure. They will clean the knee joint area and carefully examine the surrounding structures like cartilage and meniscus. If any damage is found in these structures, the surgeon might repair them alongside the ACL reconstruction.

Following this evaluation, the torn ACL is removed and a healthy graft is prepared. Tunnels are then drilled in the shin bone and thigh bone to insert the new ligament. The graft is positioned and secured within these tunnels with fixation devices for stability. Once the graft is secured, the incisions will be closed and the knee will be bandaged.

In most cases, ACL reconstruction surgery takes about 1 to 1.5 hours to complete and most patients can return home on the same day of the procedure.

What Is the Recovery Time for ACL Reconstruction Surgery?

After the surgery, physiotherapy and rehabilitation exercises begin to restore strength, stability, and movement in the knee. The patient will also be given medications to manage pain and discomfort post-surgery.

For several weeks, crutches and braces may be needed to support the knee while it heals. The surgeon will also recommend a gradual return to activities to ensure proper healing. Full recovery from ACL reconstruction surgery can take anywhere from 6 to 12 months.

It is important to be patient with yourself and follow the advice of your recovery team. Remember, open communication with your doctor and physiotherapist is vital for addressing any concerns and ensuring a smooth recovery journey.

Are There Any Risks or Complications?

ACL reconstruction surgery may carry potential risks and complications, including:

Infection
Bleeding and blood clots
Knee stiffness
Instability
Graft failure

In some cases, ACL reconstruction may fail, or the ACL may be re-injured. This necessitates revision ACL surgery, a more complex procedure compared to the initial surgery. Revision surgery often addresses scar tissue, bone changes, and removal of the old graft. It may involve a larger incision and may require a different type of graft material. Additionally, this procedure may need to be done as open knee surgery instead of arthroscopy.

While ACL reconstruction surgery carries potential risks, it is considered an effective treatment for ACL injuries, especially when performed by experienced MOH-accredited specialists. Schedule a consultation with our orthopaedic surgeon to discuss your ACL reconstruction options.

To find out more about ACL surgery in Singapore, make an appointment with our specialist at 8028 4572 or message us here.