ACL (Anterior Cruciate Ligament) Reconstruction is a surgical procedure to repair a torn ACL, one of the major ligaments in the knee. This injury is common among athletes but can happen to anyone due to sudden twists or impacts. The surgery involves replacing the damaged ligament with a graft, usually taken from the patient's own tendon or a donor. ACL Reconstruction helps restore knee stability, allowing patients to return to sports and daily activities. With advancements in medical technology, this procedure has become minimally invasive, ensuring faster recovery and better outcomes.
An ACL injury occurs when the ligament connecting the thigh bone (femur) to the shinbone (tibia) is overstretched or torn. Common causes include sudden stops, pivoting motions (common in soccer or basketball), direct collisions, or awkward landings. Symptoms include a loud "pop" sound at the time of injury, severe knee pain, swelling, instability while walking, and reduced range of motion. Without proper treatment, an ACL tear can lead to long-term knee problems, including arthritis. Early diagnosis through physical exams and imaging (MRI) is crucial for effective treatment.
Not all ACL tears require surgery—some heal with rest, physiotherapy, and bracing. However, ACL Reconstruction is recommended for active individuals, athletes, or those with multiple ligament injuries. Surgery is often advised if the knee remains unstable despite rehabilitation, or if the patient wants to return to high-demand sports. Older adults with less active lifestyles may opt for non-surgical treatments. An orthopedic surgeon evaluates the injury severity, patient’s age, activity level, and overall health before recommending surgery.
Before ACL Reconstruction, patients undergo a thorough evaluation, including medical history review, physical exams, and imaging tests (X-ray/MRI). Pre-surgery physiotherapy may be recommended to reduce swelling and strengthen surrounding muscles. Patients should avoid NSAIDs (like ibuprofen) a week before surgery to prevent bleeding. Fasting is required 8-12 hours before the procedure. Arranging post-surgery support (crutches, ice packs, and help at home) is essential for a smooth recovery. The surgeon will also discuss anesthesia options (usually general or regional) and graft choices (hamstring, patellar tendon, or cadaver graft).
There are three primary techniques for ACL Reconstruction: Autograft (using the patient’s own tendon, often from the hamstring or patella), Allograft (using donor tissue), and Synthetic grafts (less common). The most popular method is arthroscopic surgery, where small incisions and a camera-guided tool are used for precision. Another approach is the open surgery method, used in complex cases. The choice depends on the patient’s age, activity level, and surgeon’s expertise. Advances like BEAR Implant (Bridge-Enhanced ACL Repair) offer newer alternatives for certain patients.
The entire procedure typically takes 1-2 hours, and patients can go home the same day.
Recovery after ACL Reconstruction is a gradual process:
Full recovery takes 6-12 months, depending on adherence to physiotherapy. Athletes must pass functional tests before returning to sports.
While ACL Reconstruction is generally safe, potential risks include:
Choosing an experienced surgeon and following post-op care minimizes these risks.
1. How long does ACL surgery take?
The surgery usually takes 1-2 hours, with additional time for pre-op prep and recovery.
2. When can I walk after ACL Reconstruction?
Most patients walk with crutches within 1-2 weeks and without support in 4-6 weeks.
3. Is ACL surgery painful?
Pain is manageable with prescribed medications. Discomfort peaks in the first 3 days and subsides gradually.
4. Can ACL tears heal without surgery?
Partial tears may heal with therapy, but complete tears often require surgery for active individuals.
5. How soon can I return to sports?
Athletes typically resume sports in 9-12 months, after strength and stability tests.