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Alternative NamesAnterior cruciate ligament repair; Knee surgery
Definition Return to top
ACL reconstruction is surgery to replace the ligament in the center of your knee with a new ligament. The anterior cruciate ligament (ACL) keeps your shin bone (tibia) in place. A tear of this ligament can cause your knee to give way during physical activity.
Description Return to top
You will probably receive general anesthesia right before surgery. This means you will be unconscious and unable to feel pain. Sometimes, other kinds of anesthesia are used for this surgery.
The tissue that will replace your damaged ACL will come from your own body or from a donor. A donor is a person who has died and, before death, chose to give all or part of their body to help others.
The procedure is usually done by knee arthroscopy. With arthroscopy, a tiny camera is inserted into the knee through a small incision (cut). The camera is connected to a video monitor in the operating room. Your surgeon will use the camera to check the ligaments and other tissues of your knee.
Your surgeon will make other small cuts around your knee and insert other medical. Your surgeon will repair any other damage found. Your surgeon then will replace your ACL by following these steps:
At the end of the surgery, your surgeon will close your incisions with sutures (stitches) and put a dressing on them. Most surgeons take pictures during the procedure from the video monitor so that afterward you can see what was found and what was done.
Why the Procedure is Performed Return to top
We know that NOT treating a torn ACL can lead to tissue damage and early arthritis. ACL reconstruction may be recommended for these knee problems:
Before choosing to have this surgery, you should understand the time and effort rehabilitation (recovery) will take. You will need to stick to a program for 4 to 6 months before you can return to full activity. The success of the surgery depends on your sticking with your rehabilitation program.
Risks Return to top
The risks for any anesthesia are:
The risks for any surgery are:
Additional risks for this surgery are:
Before the Procedure Return to top
Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.
During the 2 weeks before your surgery:
On the day of your surgery:
After the Procedure Return to top
You will probably go home the day of your surgery. You may have to wear a knee brace for the first 1 to 4 weeks. You also may need crutches for 1 to 4 weeks. Most people are allowed to move their knee right after surgery to help prevent stiffness. You may need medicine to manage your pain.
Physical therapy can help many people regain motion and strength in their knee. Therapy can last 2 to 6 months.
How soon you return to work will depend on the kind of work you do. It can be anywhere from a few days to a few months. A full return to activities and sports usually takes 4 to 6 months.
Outlook (Prognosis) Return to top
ACL reconstruction is usually very successful. A torn ACL used to end the careers of many athletes. Now, improvements in the surgery and in rehabilitation provide much better results. These improvements include less pain and stiffness, fewer complications with the surgery itself, and faster recovery time. Most people will have a stable knee that does not give way after ACL reconstruction.
References Return to top
Phillips BB. Arthroscopy of the lower extremity. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 48.
Streich NA. Reconstruction of the ACL with a semitendinosus tendon graft: a prospective randomized single blinded comparison of double-bundle versus single-bundle technique in male athletes. Knee Surg Sports Traumatol Arthrosc. March 1, 2008;16(3): 232-8.Update Date: 2/3/2009 Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.