Informed Consent for Anterior Cruciate Ligament (ACL) Reconstruction

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Informed Consent for Anterior Cruciate Ligament (ACL) Reconstruction

Patient and Surgical Information

Nature and Purpose of the Procedure

Anterior Cruciate Ligament (ACL) reconstruction is an arthroscopic surgical procedure performed to restore stability to a knee joint that has suffered a torn or ruptured ACL. Under general or regional anesthesia, the surgeon makes several small keyhole incisions around the knee. An arthroscope (camera) and surgical instruments are inserted. If the remaining torn ligament cannot be repaired, it is cleared, and bone tunnels are drilled into the femur (thighbone) and tibia (shinbone). A replacement graft is then harvested from the patient's own body (autograft: e.g. patellar tendon, hamstring tendon, or quadriceps tendon) or obtained from a donor tissue bank (allograft). The graft is pulled through the bone tunnels and secured in place with screws, buttons, or staples. If meniscal tears or cartilage damage are present, they may be repaired at the same time. The procedure typically takes 1 to 2 hours.

Material Risks and Potential Complications

Infection: superficial skin wound infection or deep joint infection (septic arthritis), which may require repeat surgery for joint washing and IV antibiotics.
Knee stiffness or loss of range of motion: joint scarring (arthrofibrosis) that limits extension or flexion, which may require physical manipulation under anesthesia or arthroscopic scar release.
Graft failure or stretching: the reconstructed ligament tearing again or loosening over time due to trauma, premature return to sport, or failure of bone healing.
Pain in the front of the knee (anterior knee pain or patellar tendonitis), particularly if a patellar tendon autograft was harvested.
Nerve irritation or numbness around the incision sites or the front-outer aspect of the shin, usually due to saphenous nerve branch stretching.
Deep vein thrombosis (DVT) or blood clots forming in the calf or thigh veins.
Hardware irritation from the buttons, screws, or staples, occasionally requiring removal after the bone tunnels have healed.

Reasonable Alternatives

Non-operative management: progressive physical therapy focused on quadriceps and hamstring strengthening, combined with activity modification and wearing a functional knee brace during sports.
Watchful waiting: delaying surgery while monitoring symptoms during daily low-impact activities.

Rehabilitation and Recovery Expectations

Successful ACL reconstruction depends heavily on compliance with postoperative rehabilitation. Patients must use crutches and a knee brace as directed. Structured physical therapy typically begins within the first week after surgery. Achieving full knee extension early is critical. Returning to running usually takes 3 to 4 months, and returning to pivoting sports or high-impact athletics takes 6 to 9 months, subject to functional strength testing and surgeon clearance.

Questions and Understanding Confirmation

I confirm that I have had the opportunity to read this consent form carefully and ask questions of my surgeon. I understand that my active participation in post-operative physical therapy is mandatory for a successful result. I believe I am making an informed and voluntary decision.

Signatures and Verification

Patient / Legally Authorized Representative Signature
Consenting Orthopedic Surgeon Signature
Witness Signature
Date and Time of Consent
Document ID: CC-PENDING
CONSENTCOLLECT