ACL & Meniscus Surgery
ACL and meniscus tears are both common sports injuries that occur in the knee. Often, the two injuries occur at the same time.
The anterior cruciate ligament (ACL) is a ligament that runs diagonally in the middle of the knee. The ACL helps to hold the joint in place by preventing the tibia (shinbone) from sliding in front of the femur (thighbone). The ACL also helps stabilize the knee. An ACL tear can be very painful and may affect knee stability.
A meniscus is a wedge-shaped piece of cartilage located between the thighbone and shinbone that acts as a cushion and shock absorber for the knee. Your knees actually have two menisci—one on each side of the joint. Like ACL tears, meniscus tears can be painful, but most people are still able to walk on the injured knee.
Dr. Casey specializes in both ACL and meniscus surgery, and often sees patients who have sustained both injuries at the same time. Dr. Casey has over 20 years of experience in orthopedic surgery. He also treats sports injuries in many local athletes in the Terrebonne Parish Recreation District through his involvement with the Community Sports Institute at Terrebonne General Medical Center (TGMC).
Causes & Symptoms of ACL and Meniscus Tears
Both ACL and meniscus tears often occur during sports activities. These injuries can occur during direct contact or collision with another player. They can also happen when landing a jump incorrectly, rapidly changing direction, coming to a sudden stop during play, or accidentally twisting the knee.
Knee injuries like ACL and meniscus tears can produce similar symptoms, so it is important to be evaluated by a qualified medical professional to confirm the injury. Common symptoms include:
- Inability to move the knee through its full range of motion
- Feeling the knee give out from under you
With both ACL and meniscus tears, walking may be painful. However, patients with ACL tears may have more difficulty walking and putting weight on the knee because it may feel unstable. In addition to the above symptoms, meniscus tears can also cause the knee to catch or lock up if the torn piece of meniscus comes loose and drifts into the joint.
Some small or minor meniscus tears can be treated with nonsurgical methods like rest, ice, compression, and elevation, but surgery may be recommended for larger tears. A torn ACL will not heal back together without surgical reconstruction, so surgery is typically recommended for active patients.
Surgical Procedures for ACL & Meniscus Tears
Dr. Casey typically uses arthroscopy for both ACL and meniscus surgery. Arthroscopy is a minimally invasive surgical method that involves inserting a small camera into the knee to view the damaged structures in the knee and repair them by inserting surgical instruments through small incisions. Because the procedure utilizes smaller incisions, patients often have less scarring and less pain after surgery.
The procedure varies based on whether the tear is in the meniscus, the ACL, or both. If both the ACL and the meniscus are torn, Dr. Casey will typically do both procedures at the same time.
If the meniscus is torn, the damaged tissue is typically trimmed away. This procedure is called a partial meniscectomy. Removing the loose, damaged pieces of meniscus typically helps relieve knee pain. This procedure is relatively quick, and recovery time is fairly quick if no other procedures are needed. In some cases, the tear can be repaired by suturing the torn pieces back together. However, this will depend on the type of tear and the condition of the meniscus.
In most cases, a torn ACL cannot simply be sutured back together. Often, a tissue graft is needed to reconstruct the ligament. Grafts can be taken from different sources, including the patient’s own patellar tendon, hamstring, or quadriceps tendon. In some cases, a cadaver graft can also be used. Dr. Casey will discuss tissue graft options and his recommendations prior to surgery.
Once the tissue graft has been taken and prepared, Dr. Casey will use the graft to repair the torn ligament. The graft will provide a structure for new ligament tissue to grow onto.
Recovering from ACL & Meniscus Surgery
Both ACL and meniscus surgery are often done on an outpatient basis, so most patients are able to return home the day of surgery. The recovery period varies based on the procedure(s) needed. Patients that only had meniscus surgery will recover more quickly than patients who had ACL surgery or both procedures done at once.
Meniscus Surgery Recovery
Recovering from meniscus surgery is relatively quick, if no other procedures were needed. Pain is typically minimal after meniscus surgery. Most patients fully recover within 1–3 weeks, and are able to return to work soon after surgery if their job does not require physical labor. Physical therapy is rarely needed for this procedure.
If meniscus surgery is done at the same time as an ACL repair, this will increase the recovery time, as the ACL needs more time to heal properly.
ACL Surgery Recovery
Patients may experience pain for the first few days after surgery. Medication may be recommended to help manage pain. ACL repair surgery requires extensive physical therapy to restore motion in the knee and strengthen the new ligament. Patients typically participate in physical therapy for at least 12 weeks after surgery, and may continue the physical therapy program for as long as 6 months. Dr. Casey’s practice offers physical therapy onsite for the convenience of their patients, though patients are not required to use onsite services.
Full recovery from ACL surgery is much longer than meniscus surgery. Patients with clerical or sedentary jobs typically return to work within 6–8 weeks of surgery. Patients with more labor-intensive jobs are advised to wait 4–6 months before returning to work. Typically, patients can return to all normal activities within 8–12 weeks of surgery. However, athletes may not be cleared to return to sports for 6 months to a year after surgery to avoid the risk of re-injury.
ACL & Meniscus Surgery in Houma, LA
Dr. Casey has over 20 years of experience in orthopedic surgery, including ACL and meniscus surgery. He has worked with athletes throughout Terrebonne parish and surrounding communities to treat injuries like ACL and meniscus tears. If you would like to schedule an appointment with Dr. Casey, please call our office at 985-262-3906 or submit an appointment request with our convenient online form.