Dallas ACL Surgeon
650 + Reviews
The anterior cruciate ligament (ACL) is one of the four major ligaments that stabilize the knee joint and a vital band of connective tissue that links your femur, or thigh bone, to your tibia, or shin bone. This key structure helps maintain the knee’s stability and supports knee function, especially during quick pivots, sudden stops, or lateral movements common in those who play sports or lead an active lifestyle. It is also considered one of the major stabilizing ligaments responsible for controlling excessive forward movement between the lower leg bones.When the tibia shifts forward relative to the femur, increased forward movement can occur, contributing to instability. Overextension or an initial injury can lead to a complete tear, which often requires surgical treatment.
It is essential to note that anterior cruciate ligament (ACL) injuries often result from non-contact mechanisms, such as sudden directional change slowing, jumping incorrectly, awkward landings, or direct blows to the knee. Risk factors include high-risk sports like soccer and basketball, female gender, poor conditioning, a previous ACL injury, and biomechanical issues such as improper landing. ACL injuries are also seen in contact sports such as football, where football tackle symptoms may involve a knee buckle or the knee feels unstable immediately following impact. Additionally, delaying surgery for an anterior cruciate ligament injury may result in damage to other knee ligaments, articular cartilage injury, or increase the risk of meniscus tears and long-term complications like knee pain and instability.
Who Is at Risk for an Anterior Cruciate Ligament (ACL) Injury
Anterior cruciate ligament (ACL) injuries can affect individuals of all ages and activity levels, though they are more commonly seen in athletes and active adults. Sports involving jumping, pivoting, or rapid direction changes place increased stress on the knee. Prior knee injuries, muscle imbalances, and certain movement patterns may also contribute to increased risk.
Additionally, ACL injuries often involve twisting forces applied to the knee while the foot is planted, which can cause excessive forward movement of the tibia. When this occurs, the ligament may fail to stabilize the joint, leading to feelings of instability or the sensation that the knee may buckle during activity.
An orthopaedic evaluation from a Dallas ACL surgeon, Dr. Steven Thornton, can help determine individual risk factors and guide prevention or treatment strategies.
The Procedures & Treatment Options
Before considering ACL reconstruction surgery, many individuals and athletes, particularly those with a partial torn ligament, an intact ACL, or lower activity levels, may explore non-surgical options. These approaches focus on alleviating symptoms and preserving knee function. Conservative management strategies include bracing, anti-inflammatory medications, and a tailored physical therapy program supervised by a physical therapist. These non-invasive methods aim to improve range of motion, strengthen the quadriceps, hamstrings, and surrounding structures, and enhance neuromuscular control.
While some partial injuries may improve with conservative care, a complete tear is less likely to heal on its own. In these cases, the ligament heals incompletely or not at all, which may result in ongoing instability during daily activities or sports.
Physical therapy is crucial in improving stability when ACL repair is not immediately pursued. While these treatments may not restore the ACL’s integrity, they can help some active patients return to limited activities. However, conservative options are typically less effective for those with complete tears or who plan to play sports regularly.
When surgery for Anterior cruciate ligament (ACL) injury becomes necessary, a skilled orthopedic surgeon will perform ACL reconstructive surgery to replace the damaged or torn ligament with a tissue graft. This replacement tissue often comes from the patellar tendon, quadriceps tendon, or hamstring tendon autograft, and may also include allograft tissue from a tissue donor.
Cruciate ligament ACL reconstruction is a commonly performed surgical procedure within sports medicine and is often completed using arthroscopic surgery. Arthroscopic techniques allow surgeons to address knee procedures with smaller incisions while focusing on restoring knee movement and joint stability.
The goal of anterior cruciate ligament reconstruction is to restore function and stability using advanced surgical techniques, often employing minimally invasive techniques in an outpatient procedure.
Types of Anterior Cruciate Ligament Grafts Used in Reconstruction
Several graft options may be considered during ACL reconstruction. Autografts use the patient’s own tissue, commonly from the patellar tendon, quadriceps tendon, or hamstring tendon. Allografts utilize donor tissue. The most appropriate graft choice depends on multiple factors, including activity level, anatomy, and surgeon recommendation. These options are discussed in detail during the surgical planning process.
What to Expect on the Day of ACL Reconstruction Surgery
Anterior cruciate ligament reconstruction surgery is commonly performed as an outpatient procedure. Patients typically arrive on the day of surgery, undergo preparation and anesthesia, and return home the same day. Surgical details and post-procedure instructions are reviewed in advance to ensure patients understand the process and recovery expectations.
During the procedure, the knee is positioned in a completely straight alignment at specific stages to allow proper graft placement and tensioning. The surgical team focuses on recreating normal knee mechanics while minimizing disruption to surrounding structures.
Common ACL Injury Surgery FAQS
General Post Operative Care for ACL Injury Surgery
What to Eat or Drink Following Your Procedure
Although you may not have specific dietary restrictions following the successful ACL reconstruction, the following are some suggestions to make recovery easier:
- After the ACL tear surgery, you’re encouraged to ease back into eating with bland, easy-to-digest options like broth, applesauce or plain rice. Crackers and other small, light foods can also be good options.
- Move to your usual meals once your stomach settles, but avoid heavy or greasy foods if you feel queasy. Nausea can be a side effect of pain medications or other prescriptions. If you experience severe nausea accompanied by vomiting or pain, contact your surgeon right away.
- Drink water regularly to stay hydrated. Proper hydration is a key component in recovery from any type of surgery.
Caring for Incisions
Your procedure will involve incisions. Proper wound care guidelines should be followed to promote speedy healing and avoid infections or other complications.
- Leave the surgical bandage in place and undisturbed until your first follow-up visit. Some itching is to be expected during the healing process, but it’s important not to scratch around the incision area as this can cause pain, slow healing and lead to infection.
- Expect some puffiness or light spotting of blood. This is normal. If the dressing becomes soaked, wrap an extra layer of sterile gauze around it, and call us if it doesn’t stop.
- Spotting should decrease each day. If your incision oozes blood or other fluids, contact our office.
- Keep the area dry to avoid infection. After 24 hours, you can shower by sealing your brace and leg in a plastic cover. Many patients find that securing a plastic bag around the area provides sufficient protection. No baths, pools or hot tubs until your specialist gives the go-ahead.
- Don’t peel off the dressing yourself. Instead, let our team handle it at your follow-up appointment. Removing any type of dressing must be handled with care to avoid irritating incisions and causing damage or pain.
- Until you have your doctor’s approval, do not use lotions, gels or oils near the wound.
- Once the stitches are removed (typically 7-12 days post-op), you may gently rinse the area in the shower and pat it dry. You should not soak the area until we give the green light.
Pain and Medication Guidelines
The following are general guidelines for aftercare following medication use. Your doctor will provide specific instructions as they pertain to your health, prescriptions, and procedure.
- The numbing medicine used during your ACL reconstructive surgery will wear off in 4-10 hours, and knee pain may spike around day two or three as swelling builds.
- Take prescribed pain medications as directed. If they do not provide adequate relief on the partial tear or completely torn ACL site, contact our office for alternative options.
- These medications may cause drowsiness, nausea, or constipation. Eating a small bite beforehand can help, and an over-the-counter stool softener might be worth using if needed and approved by your knee specialist.
- If you’re throwing up or can’t keep medications down, call us for a possible switch or further instructions.
- No driving or handling/operating machinery while on these drugs as they can cause dizziness and cloud your judgment.
- If your health history indicates a clot risk, your specialist can provide guidance. Low-dose aspirin will be prescribed to lower that risk.
Your Mobility Following ACL Surgery
The following are some general recommendations regarding movement following your ACL surgery. Because your recovery is personal, your knee doctor can provide specific instructions at your follow-up visit:
- Swelling is normal following surgery. To reduce swelling, keep your leg propped on cushions or pillows while lying down. Keep these cushions/pillows under your knee and not your ankle.
- When getting around, stick to crutches for now. Depending on your surgeon’s guidance, you may be allowed to put some weight on your leg. However, always keep the brace locked in a straight position until further instructions.
- We encourage you to take it easy for the first 5-7 days. This will aid in healing and can prevent accidents and injury.
- You should avoid long car rides or sitting still without propping your leg up for at least a week.
- You should hold off on driving until your doctor clears you, and you should never drive under the influence of pain medication.
- If possible, take at least a week off work. When you return, try to secure a position that allows you to remain seated with your leg elevated.
Proper Usage of Your Brace
A knee brace has been placed on your knee following surgery. Proper usage of this brace is essential for recovery.
- Keep your brace on full-time in a locked straight position unless you’re doing approved exercises or sleeping. Your ACL surgeon Dallas can provide specific guidance for physical activity.
- Your brace provides protection and stability. If you need adjustments, our team can guide you.
Use a Cold Pack for Swelling
Cold can reduce swelling and provide relief from pain. Below are some general guidelines for the use of ice machine or cold packs during your recovery:
- Place a cold pack or utilize ice machine for 15-30 minutes every few hours when you’re awake for the first week.
- To prevent skin damage, always place a protective barrier, such as a towel, cloth, or sealed bag, between the ice and your skin before application.
- Always place a protective barrier, such as a towel or cloth, between the ice pack and your skin to prevent frostbite.
Movement and Stretching Guidelines
Based on your doctor’s recommendations, you can usually start light leg exercises 48 hours after your procedure.
- Small movements, such as toe wiggles and thigh squeezes, can be beneficial for improving blood flow.
- It’s important to recognize your limits. While some soreness is to be expected, you do not want to move in such a way so as to experience pain. If it hurts to move, discuss proper movements with your specialist.
- Physical therapy may be ordered following your surgery. Our office can coordinate this with you or a caregiver.
CALL US IF…
Reach out right away if you notice:
- Severe, persistent pain that does not improve with medication or radiates through your upper arm.
- Fever, chills, infection, redness, off-color discharge.
- Severe swelling, tingling, numbness or skin discoloration, particularly in the hand, fingers or forearm.
- Respiratory distress or chest discomfort.
- Bleeding or persistent fluid leakage at the incision site.
Follow-Up Appointments and Ongoing Care with a Dallas ACL Surgeon
Scheduled follow-up visits allow your Dallas ACL doctor to monitor healing, evaluate knee stability, and adjust recovery plans as needed. These appointments are an important part of ensuring safe progression through rehabilitation.
In addition to ACL reconstruction, Dr. Thornton also treats meniscal attachment injuries, MCL damage, kneecap tendon injuries, collateral ligament damage, posterior cruciate ligament injuries, and other conditions that affect knee stability and function