Before undergoing ACL surgery, be sure to ask your surgeon these 7 important questions. You don’t want to regret any of your choices after the surgery is over!
If you’re one of the estimated 100,000 people in the United States who will undergo anterior cruciate ligament (ACL) reconstruction surgery this year, you’re likely feeling a mix of anxiety and excitement. If you’re like me, you’ve been nervously googling “ACL surgery recovery” for weeks (or months).
While it’s important to be as prepared as possible for surgery and the road to recovery, don’t forget to ask your surgeon the important questions that are specific to your individual case. Here are 7 questions to ask your ACL surgeon before surgery.
1. What are my surgical options, and what is the difference between them?
ACL surgery is a type of knee surgery that aims to reconstruct the ACL or ACL graft. The ACL can either be repaired, reconstructed, or replaced with an ACL graft. The ACL runs from the thigh bone to the shinbone and stabilizes your knee from front-to-back movement.
There are a number of different graft options.
Hamstring tendons, which are taken from the hamstring muscle located on the back of your thigh, and patellar tendon grafts, which are taken from a bone bank or cadaver, can both be used to reconstruct an ACL. Allografts are ACL grafts that come from human tissue banks. The last type is a quadriceps tendon graft, which is taken from the quadriceps tendon located at the top of the thigh.
It is important to discuss your options with your surgeon to determine what’s best for your situation.
2. What is the expected recovery time for each option, and how long will I be out of work/unable to do activities that I enjoy post-surgery?
Depending on which ACL surgery is chosen, ACL rehabilitation time, protocols, and outcomes could vary. The average ACL reconstruction takes roughly 6-9 months to regain full ability and strength in your new ACL graft (times to graft maturity vary). The main graft types are listed above.
Research has shown that all autografts (tissue taken from another part of your own body) are generally better than allografts (tissue taken from a cadaver or tissue bank) for ACL surgery for individuals under the age of 35. There are positives and negatives to ACL grafts which are autografts or allografts. Again, make sure to discuss these at length with your physician to determine which is correct for you.
3. How many times have you performed this surgery, and what is your success rate (% of patients who are fully recovered)?
Don’t hesitate to ask about your surgeon’s experience like it’s a job interview. Asking these questions will allow you to gain confidence in the process.
Understanding success rates and previous surgery experience allowed me to relax and realize I was dealing with a professional who has done this over a thousand times. In addition to gaining comfort, this allows you to look behind the scenes to know what to realistically expect from your rehabilitation. While the averages don’t predict all outcomes, it allows you to begin the process from solid ground.
4. What are the risks or potential complications associated with the surgery (e.g., infection, blood clots, nerve damage)?
I think it is important that you gain a full understanding of the complete, while rare, risks of any surgery. Even a simple surgery can cause infection, reaction to anesthesia, and other more complicated problems.
While none of these complications are common, it is paramount that you understand the entire process. I do not believe in doing anything in life without knowing the full picture.
My intention is not to scare you. Rather, I want to ensure that you follow the surgeon’s protocol meticulously so that you lessen your risk of any of these issues taking place. True adherence can only come from knowledge, not ignorance. The more you know, the more you understand why the surgeon is requesting certain things be done.
During my first ACL surgery, I did not ask these questions. Although nothing bad happened, I realized rather quickly that I was careless, and lucky, that I didn’t get an infection (in my case).
5. What about physical therapy? How long is rehabilitation generally required? Do you have any recommendations for physical therapists to work with?
The surgery is only one step – recovery takes much longer by comparison. You’ll need to find out how to properly recover once you leave the hospital. It is important to discuss these questions with your surgeon during your pre-surgery appointments. You will want to know how long you are required to be out of work or unable to do your normal activities.
Therapy is a gigantic part of your recovery. In my opinion, while the surgery is important, I feel it is the therapy that truly determines the outcomes and overall success of the athlete’s return to play.
Getting the physician’s feedback on rehabilitation timelines under their protocol and recommendation for occupational and physical therapists in the area is very valuable. Make sure to get a couple of options so that you are able to pick the therapist that you feel the most comfortable with. It is important to note that you will be spending an inordinate amount of time with this individual, so research as much as you can about each option.
6. What should I expect in terms of pain relief following surgery – both during the healing process and in the long term?
Since the opioid crisis has spiraled completely out of control, it is important to get as much information as you can about pain relief.
Pain can severely limit your rehab, especially in the early stage. While this is not an ACL-specific question, it definitely factors into the overall outcome of ACL surgery. Ensuring that you are doing everything you can while being mindful of the addictive nature of the medicine is important.
During both of my ACL surgeries, I made a plan to use a set number of pills after the first 2 days. The first couple of days following surgery were the most painful. If you make it past those days and can follow a predetermined plan, you are setting yourself up for major success in your future therapy sessions. Notably, it has been found that the more pain medication an individual takes, the more sensitive to pain the individual is.
Therefore, while pain medication can be crucial during the early period following surgery, it can actually be detrimental if used in excess.
7. Do you know a medical health professional that could walk through this process with me?
It is important to holistically look at your situation as you go through this traumatic injury, surgery, and rehabilitation. It is a difficult process to embark on alone – a process I am all too familiar with. I would have given anything to have a professional openly discuss what I was feeling and provide me with the skills necessary to ensure I didn’t fall off the most productive path during the months that followed surgery.
The potential loss of identity and self-esteem, anxiousness, and depressive thoughts that follow this traumatic injury are daunting. With a professional in your corner, you could build the foundational tools necessary to minimize these negative symptoms and optimize your outcomes following surgery.
ACL surgery is not the end-all-be-all when it comes to ACL rehab. A surgeon can only do so much. The most important aspect of ACL rehabilitation is a patient’s occupational therapist. If you didn’t already have one, definitely find one following ACL surgery. It’s a complex process that you must fully understand prior to enduring it.
Additionally, you should ensure that your ACL surgeon is not the only person in your corner working toward your overall success.
While the process following ACL surgery can be overwhelming and difficult, a good occupational therapist and mental health professional will provide guidance as you move through the rehabilitation stage. Choosing your surgeon and entire post-ACL rehabilitation team carefully will assist you in your future success in sports, and more importantly, life, after ACL surgery.