ACL Reconstruction in Kaunas Lithuania

ACL reconstruction srugery price kaunas
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ACL surgery price
What is ACL?
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Anterior cruciate surgery PRICE in our clinic in Lithuania
3.700 € / 2.950 £ / 4.650 $

(ACL reconstruction surgery & rehabilitation)

The price covers pre-surgery tests, hospitalization (1-2 days), surgery, implants, anaesthesia, personal assistance, transportation and rehabilitation for 2 weeks.

What is anterior cruciate ligament?

The anterior cruciate ligament or the ACL is a hard fibrous band of tissue connecting the front of the tibia with the back of the femur. The ACL is an important component of the knee which prevents from hyperextension and provides the stability of this joint.

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How anterior cruciate ligamnet injury occurs?

The ACL is usually injured by a tear which may occur during a fierce game set of football, rugby or basketball. Also, during falls or car accidents. About 80 percent of these injuries occur without contact with another person.

The most common mechanism of the ACL tear is when a person runs and quickly changes the direction. Besides, women are more prone to ACL injuries then men. The injury of the ACL causes several symptoms such as intensive pain, swelling and shakiness of the knee. In addition, the majority of people recalls the “pop“ sound at the time of the injury.

Once a tear of the ACL is diagnosed the treatment should be considered. It may be non surgical or surgical. A non surgical treatment is administered in cases when the injury is mild and the patient is not occupied in professional sport. Actually many pastime activities like jogging, cycling or swimming may be done without undergoing ACL surgery. In cases when the knee joint is unstable or the patient is a professional athlete a surgical treatment is certainly recommended.

Anterior cruciate ligament reconstruction surgery

The ACL surgery is known as the ACL reconstruction. It is a surgical procedure when the damaged anterior cruciate ligament is replaced with a piece of functional tissue. The surgery is carried out with the assistance of an arthroscope. An arthroscope is a small fiber-optic instrument. It is inserted in the knee through two small incisions made near this joint. This enables the surgeon to inspect and operate the knee from inside without opening it. Accessory incision is made in order to take a piece of tissue which will be used to replace the damaged ACL. This piece is called a graft. According to the source of grafts they could be classified into autografts and allografts.

Autografts

An autograft is taken from the patient‘s own tissue. The main tissues used for autografts are the hamstring tendon and the patellar tendon.

The patellar tendon is a strip of fibrous connective tissue which affixes the kneecap, which is also known as patella. In this type of grafting the incision is made on the front side of the knee because the patellar tendon is located on this side. The graft is taken of the middle third of this tendon and usually is about 9 to 10 mm length. It is removed along with pieces of bone on the each end. Once this is done, tunnels are drilled in the femur and tibia in order to affix the graft into the natural position of a normal ACL.

The greatest advantage of this type of ACL reconstruction is a great fixation. This is because of the bone pieces at the ends of the graft. They are fixed with small screws when the graft is threaded into the bone tunnels and secured into the right place. However there are some disadvantages like the risk of a rupture of the patellar tendon or even the fracture of the kneecap. Moreover, patients may suffer from anterior knee pain. It comes during activities that need kneeling and could last years after the operation. Also, the scar is bigger as compared to a hamstring tendon grafting and it is seen from the front side of the knee.

The hamstring muscles are located on the dorsal side of a thigh. There are three hamstring muscles: semitendinosus, semimembranosus and biceps femoris. Every muscle has a tendon, a strong fibrous tissue which connects it to the bone. The graft is mostly made of semitendinosus tendon combined with gracilis tendon (which is not hamstring) in order to increase the strength of the graft.  There are various methods of securing this graft into the bone tunnels, usually involving washers and screws. The main advantage of this type of the ACL reconstruction is that it causes less pain as compared to a patellar tendon surgery. Also, the incision is smaller so the scar is not very visible. However, the fixation of the graft is not as reliable as in reconstruction with patellar graft.

Allografts

An allograft is taken from a donor‘s body. The main advantage of using a donor‘s (which is usually a cadaver) tissue is that the patient does not have to undergo an additional injury while removing his own tendon . Consequently, the recovery period becomes shorter. However, there is always a risk of rejection because the patient‘s immune system fights against the nonnative tissue. Also, allografts are slightly weaker than autografts. This is because allografts are sterilizated and irradiated in order to eliminate infectious agents.

Moreover, in 1980 synthetic ligaments appeared to be a great alternative to natural grafts. These prostheses were made of various materials such as carbon fibers, polyester, polypropylene and Dacron (this is a trademark for polyester fiber). However, each of these materials caused serious side-effects like cross-infection, allergy, synovitis, recurrent instability and knee osteoarthritis. Despite many experimental studies, currently no prosthesis equal to a biological graft has been found.

The type of the graft is not the only factor to consider. There are some cases when undergoing the ACL reconstruction is highly inadvisable: sever knee arthritis, infection of the knee, skeletal immaturity in very young patients. Even if none of these conditions is diagnosed, the patient should be informed about the complications which could develop during or after the operation. These are infection, bleeding, injuries of nerves, knee stiffness, recurrent instability caused by rupture or stretching of the reconstructed ligament, rupture of the patellar tendon, fracture of the kneecap, pain, deep vein thrombosis.

Recovery after anterior cruciate ligament surgery

Usually the ACL reconstruction is performed smoothly and recovery period begins at the same day. Painkillers, ice compresses and elevation are used immediately after the operation in order to prevent intensive pain and swelling of the knee. It is important to keep the knee in a position of full extension because it helps to retrieve full functions of this joint quicker. Usually patients are able to stand and walk delicately within 24 hours after the operation. In first 2 weeks of rehabilitation special equipment like crutches, braces and props are used while walking or exercising in order to reduce a strain on the operated knee. A physical therapy is the most important remedy during whole recovery process which lasts about 6 to 12 months.

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