ACL reconstruction is surgery, usually done arthroscopically, that rebuilds a torn anterior cruciate ligament using a tendon graft in its place. This guide explains when it may be recommended, how it is done and how recovery usually goes.
Note: This is general information. The decision to operate is made with your surgeon after an in-person examination and imaging, and no specific result can be guaranteed.
When may the operation be recommended?
Surgery may be considered in situations such as:
- The knee keeps feeling unstable despite non-surgical care
- An athlete who wants to return to sports involving pivoting and cutting
- Related injuries such as a meniscus tear
- Daily activity or work affected by knee instability
- Repeated episodes of the knee giving way
What does the operation address?
The operation addresses the consequences of an ACL tear:
- A torn ACL does not usually regain its function with rest alone
- An unstable knee can expose the cartilage to further injury
- The injury typically comes from a twist, a bad landing or a collision
Diagnosis
Before surgery, the surgeon assesses knee stability by examination and reviews MRI images to define the tear and any related injuries. Your general health and activity level are considered when choosing the most suitable approach.
Treatment options
Non-surgical treatment
Surgery is not needed for everyone with this injury. Some patients manage with rehabilitation and adjusting their activity.
Non-surgical care includes physiotherapy, muscle strengthening and a knee brace when needed.
- Physiotherapy before surgery to prepare the knee
- Adjusting activity and avoiding movements that provoke instability
- A brace when needed
Surgical treatment
In the operation the surgeon uses a substitute tendon, fixed arthroscopically in place of the torn ligament. It is done through small incisions, and related injuries such as a meniscus tear can be treated during the same procedure when needed. Your surgeon will explain the graft choice, the anesthesia and the details for your case.
Every operation carries possible risks such as infection, stiffness, blood clots and persistent instability, which your surgeon will discuss before you decide.
Recovery and rehabilitation
Rehabilitation after the operation is as important as the operation itself, and Dr. Hourani pays particular attention to it. Recovery time varies from person to person and is set by the surgeon after assessment. Read about knee rehabilitation and returning to sport.
- Controlling pain and swelling and caring for the wounds
- Regaining full straightening and bending of the knee
- Normal walking and muscle strengthening
- Balance and movement-control exercises
- Sport-specific exercises
- A gradual return once criteria set by the surgeon are met
When to see the doctor
Contact your surgeon promptly after the operation if:
- You develop a fever, or redness or discharge from the wound
- Pain or swelling clearly increases
- You have pain and swelling in the calf
- The foot changes colour, turns cold or becomes numb
- You have trouble breathing or chest pain, which is an emergency