No matter what type of surgery you are going to have, being put under anesthesia and having a stranger cut into you is cause for concern; so, preparation is key. First, you need to find a surgeon who seems to know what he or she is doing. In fact, it’s not a bad idea to get more than one opinion until you find someone who seems trustworthy. Second, ask questions and listen to the answers. ACL surgery is still being studied and there are several different approaches to the process. Each option comes with different pros and cons, but there is rarely a clear and decisive winner. Since the ACL does not regenerate itself, the torn ligament will be taken out during surgery and then it will be replaced by a graft. This graft can be harvested from your own body or from a cadaver depending on your preference. Cadaver grafts, or allografts, generally don’t last as long as autografts; so, if you are having the surgery before the age of 40 it is generally advised not to pursue the allograft option. At my 20 years of age, this narrowed down my choice to two autograft options: the hamstring graft or the patellar graft. My choice ultimately fell to the patellar graft after weighing the risk of sustaining hamstring injuries post-op against not being able to kneel properly for the foreseeable future. I decided kneeling was sort of overrated, and thus the middle third of my patellar was destined to become my new ACL.
Throughout my decision process I didn’t rely solely on my surgeon and friends, I also painstakingly searched the internet to see how others had dealt with the surgery, what I should expect, and how I should proceed to prepare for my outpatient ACL procedure (These are naturally all questions my surgeon had already answered, but there’s nothing like the internet to give you some reassurance!). While it helps to know what you are getting yourself into, the description of what you will feel like post-op is nothing compared to the reality of the situation.
Even though it is an outpatient procedure, it’s best to plan to spend your whole day at the surgery center, because the nurses are not allowed to discharge you until your pain is manageable and under control. This could take half an hour or several hours depending on different factors, but most often it will take longer than you think. The day-of countless nurses, physicians, and doctors will ask you which leg you’re being operated on, even though it already has a beautiful sharpie scribble all over it. You will say it so often that you start to question if you have been giving the right answer, but don’t get too annoyed about it, because endless questioning is better than when they open up the wrong leg.
I can’t tell you what actually happens during surgery because I was quite knocked out at the time and happier for it, but I woke up in unimaginable pain, unable to sit up, and unable to tell nurses what was even wrong. I don’t remember much of this part because my brain has thankfully repressed a lot of it; so, if you want to hear the whole horror of waking up after ACL surgery it is best to talk to a person who has watched someone else do it. In any case, it took them hours to get my pain under control, and they only succeeded by pinching the nerve in my leg effectively making it impossible for me to move my right leg at all. This sensation lasted for three days, after which I was finally able to start my recovery.
Recovery is next on the agenda and it’s still an ongoing process…