The ACL (Anterior Cruciate Ligament) in the knee is very important for keeping it stable. This ligament joins the upper leg (femur) and lower leg (tibia) bones to each other. There are chances of an injury in the ACL while over-straightening of your knee, bending or twisting it, landing down incorrectly after a jump or while playing football. Women are more susceptible to contracting ACL injury.
When is ACL Surgery performed?
ACL reconstruction surgery is performed when the ligament is severely impaired, and conservative treatments do not help. For instance, when the anterior cruciate ligament is completely torn. ACL reconstruction is a minimally invasive procedure during which a surgeon makes a few small incisions and inserts surgical instruments and an arthroscope. When ACL ligament injury (complete or partial) is accompanied with other damages such as meniscus tear or a PCL tear, surgery may become necessary.
You can refer to the article here which throws more details on what factors are typically considered by experienced surgeons to suggest an ACL surgery.
During an ACL reconstruction surgery, a surgeon removes the torn ACL and replaces it with a new tissue that can be taken from the patient’s patellar tendon or the hamstring or a donor’s tendon.
After this, the surgeon checks the strength of the graft to see whether it is strong enough to hold your knee together. The graft should remain stable even when the knee is bent or moved. Post this, the incisions are stitched up. The patient is then moved to the hospital ward for further recovery. The surgeon provides the patient with an ice water bandage to reduce swelling. The physical therapist creates a detailed recovery program for the patient for speedy and successful return to normal life. It is very important that the patient follows it meticulously.
During the rehabilitation, tendon used for a replacement goes through a process called liagmentization after the surgery, that refers to a slow process by which a tendon tissue changes its characteristic to become more ligament like.
The program may contain specific exercises for improving the life of the operated knee. The exercises facilitate improving your mobility, balance, strengthening the knee muscles and overall ability to walk normally. Again, the operated knee is likely to remain stiff for a few weeks; pain-killers then become a necessity.
Patients need to maintain their legs in a raised position while resting. The patient may also need to move around with the help of crutches for two weeks post surgery. The period you will take for returning to your work-life depends on the intensity of work you have. For instance, if you have a desk job, then the period is two weeks, similarly, if it is manual or sports related work, then the cooling off period is six months.
Your doctor may recommend some knee braces that help to keep the knee in immobile and help recover soon.
8 important steps before having ACL surgery:
- Talk to a doctor
- Get an x-ray and MRI
- Choose an experienced orthopedic surgeon
- Before surgery: Rehab/strengthen the knee as much as possible
- Graft and fixation choice: Choose the type of ACL surgery you want
- Assess the postoperative costs that are likely to be incurred including medicine and physiotherapy.
- If you have medical insurance Have a thorough conversation with your health insurance company to learn how much % your insurance will cover you. Fully document the questions, answers, and conversation.
- Now that you have cost information, you are able to make an informed decision on whether or not to have the surgery.
ACL surgery cost breakdown
1. ACL surgery Pre-ops Costs
Pre-ops tests carried out for ACL surgery typically include the following:
Your surgeon may refer some diagnostic tests before ACL surgery. Some tests are necessary for all patients before surgery. Others tests are done only if you are at risk of certain health issues.
- Physical Examination
- Blood Test
- Chest x-ray
- Coagulation Test
Depending on the case to case basis, some tests may not be required. The average cost for pre-ops test can be expected between Rs 6000 to Rs 15000.
2. ACL Surgery Costs
The surgery cost typically includes the following.
- Surgeon’s Fee
- Anesthetic Fee
- Operating Theatre Charges
- Graft cost
- Cost of graft fixation screws/material
- Surgery Consumables
- Medicines for anesthesia
3. Costs after ACL surgery
After the ACL surgery, one has to stay back in the hospital for at 2 days and undergo the postoperative surgery rehabilitation, which includes guided movement in the presence of a trained physical therapist, and pain-relief medicines. Costs incurred during this period are:
- Medicines for pain relief
- Rehabilitation and physiotherapy appointments
- Consumables (dressings, knee braces) and crutches cost
- Post-surgery Hospital Stay for self and companion if any
Variations in ACL Surgery Cost
It is a common experience that when one visits several hospitals, one can find a lot of variations in the quoted cost for ACL surgery. It can be confusing for an average patient to hear very different prices for the same procedure, but many times, there are genuine reasons for these variations.
ACL surgery cost in India
The cost of ACL reconstruction surgery in India ranges between Rs 75,000 to Rs 1.5 lakhs and varies with the type of procedure, surgeon, and quality of graft, method of fixing the graft, facility. Following the surgery, additional costs of Rs 15,000 to Rs 20,000 may be incurred in treatments such as post-surgery physiotherapy, which is essential for a good recovery.
How to manage the ACL surgery Costs?
Let’s take, for instance, a patient finds it hard to afford the projected cost but is reluctant to compromise on quality and a successful outcome, what are the options?
1. Find a good orthopedic surgeon who is not super-expensive
There are many ways to locate highly qualified doctors who are as qualified and experienced as the most sought after specialist in your city, but not so expensive.
2. Select a graft which is optimal for you
Choosing the right graft for ACL reconstruction depends on several factors such as age, functional demands, and pre-existing anterior knee pain. Discuss what option will be most suitable for you.
3. Evaluate and reduce avoidable expenses
Do you need to have a private room and a full-time nurse? Can you consider undergoing your ACL surgery by an expert doctor in a hospital that does not provide luxury services like five-star hotels?
4. Prepare yourself for surgery
You may be able to help yourself greatly by preparing yourself for surgery, both physically and mentally. Few helpful tips include engaging in pre-operative physiotherapy; taking a balanced diet; maintaining blood-sugar levels, in case you have diabetes; and quitting smoking.
5. Medical Insurance
If you already have medical insurance, then the good news is that most of the medical insurance companies in India now cover ACL surgeries. Patients need to talk to their surgeon beforehand and acquire all the essential documents. Authorization from the medical insurance company is required before you schedule your surgery, for them to validate the claim.
It may be prudent to find out, how much of the cost will they reimburse. Although it might not be the total amount, it surely makes the treatment affordable.
If ACL surgery cost is the primary consideration that is coming in the way of your aspirations to live a pain-free and active life, a little effort can help you find an optimal treatment option that does not compromise on quality and care. For more information, do get in touch with us through email at [email protected] or message us on WhatsApp at +91-9640378378.
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Dr. Kaleem Mohammed graduated as a Bachelor of Physiotherapy in 2014 from Deccan College of Physiotherapy, affiliated to Dr. N.T.R. University of Health Sciences, Vijayawada, India. Dr. Kaleem is an expert at handling physiotherapy needs of patients suffering from orthopedic and spinal conditions and post-surgery rehabilitation. Dr. Kaleem is associated with HealthClues since its inception where he facilitates diagnosis and advanced consultation with senior doctors. He is also a medical researcher and prolific writer who loves sharing insightful commentaries and useful tips to educate the patient community about fitness, treatment options, and post-treatment recovery.