Find Top Doctors for ACL Surgery

Why Is ACL Surgery Needed?

ACL surgery is a medical operation to repair or replace the anterior cruciate ligament (ACL) in the knee. The ACL is one of the key ligaments that helps stabilise the knee joint and allows smooth movement when you walk, run, or twist. When this ligament tears, most often from sports injuries, sudden stops, or awkward twisting, it can cause pain, swelling, and a feeling that the knee will “give way”.

Because the ACL does not heal well on its own, surgeons often recommend ACL reconstruction surgery to restore knee stability and function. During the procedure, the damaged ligament is removed and replaced with a graft, a piece of tendon taken from another part of the body or from a donor. ACL surgery helps patients return to normal activities, especially if they are active or the knee is unstable.

Purpose & Benefits of ACL Surgery

● Restores knee stability when the ACL is torn.

● Reduces pain and swelling related to ACL injury.

● Improves ability to walk, run, and pivot without the knee giving way.

● Prevents further damage to other knee structures like cartilage and meniscus.

● Help athletes return to sports with confidence and safety.

● Offers a long-term solution compared with non-surgical care in many cases.

Who May Need ACL Surgery?

ACL surgery may be recommended for people who:

● Have a complete or significant ACL tear confirmed by MRI or examination.

● Experience knee instability during daily activities.

● Are active in sports or physical work that stresses the knee.

● Have additional knee injuries such as meniscus tears or cartilage damage.

● Wish to return to full activity and reduce future risk of knee injury.

Your surgeon will review your symptoms, physical tests, and imaging scans to decide if ACL surgery is the best option.

Types of ACL Surgery

1. Arthroscopic ACL Reconstruction

This minimally invasive approach uses a small camera (arthroscope) and tiny instruments inserted through small incisions around the knee. It allows the surgeon to rebuild the ACL with less damage to tissues.

2. Graft Choices

ACL reconstruction involves replacing the torn ligament with a graft. Common graft types include:

● Patellar Tendon Graft: Tendon from the front of the knee.

● Hamstring Tendon Graft: Tendon from the back of the thigh.

● Quadriceps Tendon Graft: Tendon above the kneecap.

● Allograft: Donor tissue from a tissue bank.

The choice of graft depends on age, activity level, knee condition, and surgeon preference.

ACL Surgery Procedure: Step-by-Step

1. A full medical check, imaging (MRI/X-ray), and a discussion of graft options and risks.

2. General or regional anesthesia is given so you are asleep or numb from the waist down.

3. Small incisions are made around the knee, and an arthroscope (tiny camera) is inserted so the surgeon can view the inside of the knee on a screen.

4. The damaged ACL remnants are removed to prepare the knee for the graft.

5. Holes (tunnels) are created in the thighbone and shinbone. The chosen graft is passed through these tunnels to replace the torn ligament.

6. The graft is secured using screws, buttons, or anchors so it stays in place while healing occurs.

7. The small incisions are closed with sutures or staples, and sterile dressings are applied.

The surgery usually takes 1 to 2 hours, depending on complexity and graft type.

Recovery & Aftercare

After ACL surgery:

● Hospital Stay: Many patients go home the same day or stay overnight for pain management.

● Pain Control: Pain medicines help manage discomfort in the first few days.

● Physical Therapy: Rehab begins soon after surgery to strengthen the knee and improve range of motion.

● Crutches or Brace: You may use crutches and a knee brace as advised while the graft heals.

● Return to Activities: Full recovery and return to sports often takes 6–12 months, guided by your therapist and surgeon.

Regular follow-ups ensure proper healing and a progressive increase in activity.

Risks & Possible Complications

ACL surgery is common and generally safe, but some risks include:

● Infection at the surgical site.

● Bleeding or blood clots in the leg.

● Knee stiffness or limited motion.

● Graft failure or looseness over time.

● Nerve or blood vessel injury near the knee.

● Pain surrounding the kneecap or donor site (if a tendon was taken).

Your surgeon will explain how to reduce these risks before the operation.

ACL Surgery vs Other Treatments

● Surgery vs Physical Therapy:

Physical therapy helps strengthen muscles and improve movement, but it does not fix a torn ACL. Surgery restores mechanical stability.

● Surgery vs Bracing Alone:

Braces support movement but do not replace the torn ligament. Surgery offers long-term stability for active individuals.

● Surgery vs Rest and Activity Modification:

Rest may relieve pain, but for many active patients or those with instability, ACL reconstruction gives the best chance of returning to full activities.

Your surgeon tailor's advice based on your goals, activity level, and knee condition.