DR. ONG KEE LEONG
Arthroscopic Ligament Reconstruction
Arthroscopic ligament reconstruction is a minimally invasive surgical procedure that repairs or replaces damaged ligaments, often in the knee or shoulder joints. This technique uses small incisions and a camera (arthroscope) to visualise the joint interior while instruments repair the damaged tissue. Patients with ligament tears, such as anterior cruciate ligament (ACL) injuries, may require this procedure to restore joint stability and function.
Book AppointmentPotential Risks and Complications
Arthroscopic ligament reconstruction, like all surgeries, carries risks. Infection can occur but usually responds to antibiotics. Blood clots are a possibility, though early movement and sometimes medication can reduce this risk. Graft failure may happen due to technical issues, healing problems, or re-injury. Some patients may experience stiffness or limited mobility, which may require additional therapy or a second procedure. Nerve injuries causing numbness or weakness are rare and often temporary. Hardware issues, such as pain from fixation devices, may necessitate removal after healing. Most complications can be managed effectively, and serious adverse events are uncommon.
Indications for Arthroscopic Ligament Reconstruction
The following conditions may necessitate arthroscopic ligament reconstruction when conservative treatments have not provided adequate relief or improvement.
- Complete ligament tear: A fully torn ligament cannot heal on its own due to the gap between torn ends. Reconstruction replaces the damaged ligament with a tissue graft to restore joint stability.
- Partial ligament tear with instability: Some partial tears cause significant joint instability despite being incomplete. These tears may require surgical intervention when they affect daily activities or athletic performance.
- Failed conservative treatment: Non-surgical approaches such as physical therapy, bracing, and activity modification may prove ineffective for certain ligament injuries. Surgery becomes an option after these methods fail to resolve symptoms.
- Athletic requirements: Athletes who participate in pivoting, cutting, or jumping sports need full ligament function to perform safely. Reconstruction helps these individuals return to their pre-injury level of activity.
- Combination injuries: Ligament tears often occur alongside other joint injuries like meniscus tears or cartilage damage. A combined surgical approach addresses all issues simultaneously.
Surgical Techniques
- Autograft reconstruction: This technique uses tissue from the patient’s own body to create the new ligament. The surgeon harvests tendon tissue, typically from the hamstring, patellar tendon, or quadriceps tendon. Autografts generally have good incorporation rates and lower risk of disease transmission. The harvest site will have some associated pain and weakness during early recovery, which requires additional rehabilitation.
- Allograft reconstruction: This method uses donated tissue from a cadaver to create the new ligament. Allografts eliminate harvest site pain and reduce surgical time since no additional incision for graft harvesting is needed. However, they may take longer to incorporate into the body and carry a small risk of disease transmission.
Step-by-Step Procedure
Anaesthesia Administration
Anaesthesia is administered, either general (inducing unconsciousness) or regional (numbing only the surgical area). Vital signs are continuously monitored throughout the procedure.
Portal creation
Strategic small incisions (portals) approximately 1 cm in length are made around the joint. Typically, 2-4 portals are created, carefully placed to provide optimal access while avoiding important structures like nerves and blood vessels.
Joint examination
The arthroscope (a thin tube with a camera) enters through one portal, transmitting high-definition images to monitors. This allows for a comprehensive examination of all compartments of the joint, documenting the condition of cartilage, ligaments, and other structures. Additional instruments are inserted through other portals to probe and manipulate tissues.
Graft preparation and placement
The selected graft tissue (autograft or allograft) is sized, cleaned, and prepared to the appropriate dimensions. Specialised instruments are used to create anatomically positioned bone tunnels that correspond to the original ligament attachment sites. The graft is then carefully threaded through these tunnels and securely fixed at both ends using appropriate medical fixation devices.
Final assessment and closure
Before completion, the reconstructed ligament is tested through a range of motion to ensure proper tension, stability, and function. All instruments are removed, and the small incisions are closed with sutures or surgical tape. A sterile dressing is then applied.
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For Singaporeans & Singapore Permanent Residents
Preparing for Surgery
- Medical evaluation: A thorough assessment of your overall health includes blood tests, imaging studies such as MRI, and sometimes additional consultations for patients with other medical conditions. This evaluation helps identify any factors that may increase surgical risks or affect recovery.
- Medication adjustments: Certain medications affect bleeding risk and must be temporarily stopped before surgery. Blood thinners, aspirin, anti-inflammatory drugs, and some supplements require modification under medical supervision. You will receive specific instructions about which medications to continue, adjust, or stop, and the exact timing for these changes.
- Fasting guidelines: Before surgery, you must avoid all food and drinks to prevent anaesthesia complications. Typically, this means no food for 8 hours and no clear liquids for 2 hours before your procedure. Small sips of water with approved medications are the only exception.
Post-Surgical Care and Recovery
- Immediate care and pain management: Following surgery, your vital signs and surgical site will be monitored. Pain is managed with prescribed medications, and patients can return home the same day. Use cold therapy, elevation, and compression garments to control swelling and discomfort during the first several days.
- Mobility and rehabilitation progression: You will have specific weight-bearing restrictions requiring assistive devices initially. Physical therapy advances through several phases over 6-12 months—beginning with range of motion exercises, progressing to strength building, and finally incorporating activity-specific training for those returning to athletics or physically demanding occupations.
- Return to activities and follow-up care: Daily activities resume gradually, with sedentary work possible within 1-2 weeks and physical jobs typically requiring 2-3 months. Athletic activities usually require 9-12 months before full participation. Regular follow-up appointments will track your healing progress and provide recommendations for long-term joint protection.
Benefits of Arthroscopic Ligament Reconstruction
Restored joint stability
The procedure recreates the structural support that was lost when the ligament was damaged. This stability prevents abnormal joint movement that can lead to falls, giving way sensations, or further injury.
Return to physical activities
Many patients can resume sports and exercise after proper rehabilitation. The reconstructed ligament allows for movements that were previously limited or painful.
Prevention of further damage
Unstable joints with torn ligaments can damage surrounding structures like cartilage and menisci. Reconstruction helps prevent this secondary damage that can accelerate joint degeneration.
Minimally invasive approach
Arthroscopic techniques use small incisions rather than large ones required for open surgery. This approach preserves more healthy tissue around the joint.
Reduced pain
Many patients experience less chronic pain after successful ligament reconstruction and rehabilitation. The procedure addresses the underlying mechanical problem causing discomfort.
Why Do Patients Choose Dr Ong Kee Leong?
- Dr. Ong Is Passionate In Sports, Giving Him A Deep Understanding Of Sports-Related Injuries And How They Can Be Treated
- Personalised And Professional Approach To Deliver High-Quality Orthopaedic Care Based On The Most Up-To-Date Literature
- Detailed Aftercare Plan To Ensure Smooth, Long-Term Recovery
- Fellowship Trained Surgeon With 15 Years Of Experience In Orthopaedic Conditions
- Problem-Oriented, Well-Organised and Individualized Treatment Plans Catered To Your Specific Needs
- Specialist In The Management Of Sports Injuries And Degenerative Conditions Of The Shoulder And Knee Joints
- Knowledgeable And Pleasant Clinical Staff To Assist You With Your Every Need Detailed Aftercare Plan To Ensure
- Our Care Is Conveniently Accessible At Mount Elizabeth Novena and Farrer Park Hospital
- Minimal Waiting Time For Initial Consultation
- Assistance With Medical Claims (e.g. Medisave & Integrated Shield Plans)
About Dr. Ong Kee Leong
Senior Consultant, MBBS (Singapore), MMed (Ortho), FRCSEd (Ortho)
Dr. Ong Kee Leong is a fellowship-trained orthopaedic surgeon. He subspecializes in shoulder and knee, foot and ankle, hand wrist and elbow surgeries, arthroscopic sports surgery, and the management of sports-related injuries.
He has been registered with the Singapore Medical Council as a specialist in Orthopaedic Surgery since 2011.
- MBBS, National University of Singapore (NUS) Faculty of Medicine 2001
- Member of the Royal College of Surgeons of Edinburgh 2007
- Master of Medicine in Orthopaedic Surgery (NUS) 2007
- Fellow of the Royal College of Surgeons of Edinburgh in Orthopaedic Surgery 2011
- Health Manpower Development Plan (HMDP) Scholarship, Ministry of Health 2012-2013:
- Sports Surgery and Arthroscopy in Germany (Hannover)
- Adjunct Assistant Professor, Lee Kong Chian School Of Medicine, Nanyang Technological University
- Senior Clinical Lecturer, Yong Loo Lin School of Medicine, NUS
Awards & Teaching
- Dr. Ong had received numerous awards such as Best Service and Eastern Health Alliance Caring (Gold) Awards.
- He also has an interest in clinical research and has written papers in multiple peer-review journals. As a Core Faculty of Singhealth Orthopaedic Surgery Residency Program, he oversees the training of junior orthopaedic surgeons.
- Regularly invited to teach local and regional surgeons in Shoulder and Knee Surgery Courses.
- He is a recipient of multiple teaching awards including the Singhealth Residency Outstanding Faculty Awards from 2014-2016 and Changi General Hospital Outstanding Educator Awards 2015-2016.
Frequently Asked Questions
Will I need a brace after surgery?
Most patients receive a hinged knee brace after ligament reconstruction to protect the repair during early healing. Your surgeon will adjust it to allow increasing motion as you recover. Duration varies by procedure—some protocols require weeks of use, others longer for certain activities.
How long will the reconstructed ligament last?
Successful reconstructions typically function well for many years, with studies showing good outcomes at 10+ years. Durability depends on surgical technique, graft choice, rehabilitation compliance, and activity level.
Can I avoid surgery for my ligament tear?
Some injuries, especially partial tears with minimal instability, may respond to non-surgical management with physical therapy and bracing. This approach suits patients with lower physical demands who can modify activities. The decision should consider age, activity goals, degree of instability, and associated injuries.
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(Please ask for Dr Ong Kee Leong)
our clinics
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Mt Elizabeth Novena
- 38 Irrawaddy Road #06-59/60/61 Mt Elizabeth Novena Specialist Centre Singapore 329563
- klong@sog.sg
- (65) 6884 6788
- (Ask for Dr Ong)
- (65) 9652 5022
-
Mon – Fri : 9:00 am – 5:00 pm
Sat : 9:00 am – 1:00 pm
other practice locations
Farrer Park Hospital
- 1 Farrer Park Station Road #14-06 Connexion Singapore 217562
- klong@sog.sg
- (65) 6884 6788
- (Ask for Dr Ong)
- (65) 9652 5022
-
Mon – Fri : 9:00 am – 5:00 pm
Sat : 9:00 am – 1:00 pm
Mt Alvernia Medical Centre
- 820 Thomson Road #07-53 Mt Alvernia Medical Centre D Singapore 574623
- klong@sog.sg
- (65) 6884 6788
- (Ask for Dr Ong)
- (65) 9652 5022
-
Mon – Fri : 9:00 am – 5:00 pm
Sat : 9:00 am – 1:00 pm
"Moving your body the way nature intended is a freedom not well appreciated until it is lost. We are passionate about getting you back in the game, and staying in the game. Our team is fully committed to returning you to the life and activities you love."
Billing & Payment
Consultation fees are charged based on length of consultation, and start from SGD$200 (within 30 minutes).
Modes of Payment
We accept the following modes of payment:
- Cash
- PayNow & PayLah
- All major Credit Cards
If you are insured and would like to use a Letter of Guarantee (LOG) from the major insurers in Singapore, please contact us and our friendly clinic staff will assist you and provide more information if required.
Can I Claim Through My Medisave Account? (For Singaporeans and PR)
Yes, you can. Our Clinic is an accredited day surgery clinic by the Ministry of Health. Singaporeans and Permanent Residents may use their Medisave for eligible orthopaedic inpatient procedures and hospitalizations.
The exact amount would depend on the complexity of the procedure. If you have any enquiries, feel free to speak to our friendly clinic staff about using your Medisave account.
Integrated Shield Plans (Singaporeans and PRs)
Yes, patients who have purchased Integrated Shield plans with riders for co-insurance and deductibles will be able to use them in our clinic for eligible procedures. For more information, contact us to find out if your procedure is claimable.
The 5 Approved Integrated Shield Insurers are:
- NTUC Income’s IncomeShield and Enhanced IncomeShield
- American International Assurance International Co’s (AIA) HealthShield Gold
- Great Eastern Life Assurance Co’s SupremeHealth and SupremeHealth Plus
- Prudential Assurance Co’s PRUShield
- AXA Shield