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ACL reconstruction
Category: Bone, Joint & Spine Procedures · All bone, joint & spine procedures
What it is
Anterior cruciate ligament (ACL) reconstruction replaces the torn central knee ligament with a graft — usually tendon taken from your own hamstring or kneecap tendon, sometimes donor tissue — fixed inside tunnels drilled in the shin and thigh bones.
Why it is done
It is offered mainly to people with knee instability (giving way) after ACL rupture, especially those who are active, play pivoting sports, or whose work demands a stable knee. Some people manage well without surgery with rehabilitation alone.
How to prepare
Prehabilitation physiotherapy to restore full straightening and reduce swelling improves results. You will have assessment, MRI review, and fasting before day-case or short-stay surgery. Discuss graft choices and their trade-offs with your surgeon beforehand.
What happens during the procedure
Under general anaesthetic (often with a nerve block for pain relief), the surgeon inspects the knee arthroscopically, prepares the graft, drills the tunnels, fixes the graft and checks stability. Associated meniscus or cartilage injuries are treated in the same operation. It takes about one to one and a half hours.
Afterwards — recovery & results
Rehabilitation is the real treatment: a structured programme over nine to twelve months rebuilding strength, balance and sport-specific skills, with milestones before running and pivoting. Crutches are used early; most people return to desk work within one to two weeks. Return to competitive pivoting sport is usually no earlier than nine months and only after passing strength and function tests.
Risks & considerations
Risks include infection, blood clots, stiffness, graft re-rupture (higher in young active patients returning early to pivoting sports), ongoing instability and donor-site discomfort. Your surgeon will discuss rates and how rehabilitation reduces them.
Watch: ACL reconstruction videos
Real procedure videos from the MedicalVideos.com library. Some clinical footage is graphic — that is the nature of a medical video library.
Related guides on MedicalVideos.com
Frequently asked questions
Can I just do physio instead?
Some people ('copers') regain a stable knee with rehabilitation alone, especially if they avoid pivoting sports. Recurrent giving way, however, risks further meniscus and cartilage damage, which is why surgery is often recommended for the unstable knee.
Why wait months to play sport again?
The graft biologically remodels and is weakest in the early months even though the knee feels good. Returning too early is the biggest modifiable risk for re-rupture.
Related procedures — Bone, Joint & Spine Procedures
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