ACL: Anterior cruciate ligament reconstruction

The anterior cruciate ligament is one of the main ligaments in the kneeACL reconstruction surgery is a surgical procedure that can help many individuals recover with full function to the knee following an ACL tear. Most ACL injuries happen during sports and fitness activities such as aerobics, basketball, volleyball, football and soccer, where the knee can be twisted or overextended.

Successful ACL reconstruction surgery tightens the knee and restores stability; however, not everyone who tears an ACL requires ACL reconstruction. Sedentary individuals who forgot sports that involve a lot of quick stops or changes in direction usually recover well with conservative treatments and physical therapy. ACL reconstruction surgery is often recommended if:


  • An individual is an athlete and wants to continue participating in sporting events
  • An individual is young and physically active
  • An individual injures one or more ligaments in the knee
  • An individual’s knee buckles during daily activities such as stair climbing


Before ACL reconstruction surgery, a doctor may suggest going to physical therapy several weeks before undergoing surgery in order to restore the knee’s full range of motion.  Consultation in regards to any allergies or medications is also required in order to reduce the risk of complications, such as bleeding, during surgery. It is important to avoid taking any medications (other than the ones advised by the doctor), eating or drinking anything after midnight on the night before the surgery. Arranging for transportation to and from the hospital as well as home care during recovery after surgery is also recommended in order to help an individual regain proper strength and knee function. 

The procedure involves making small incisions around the knee joint and placing a narrow fiber optic viewing scope into the knee joint to help guide the placement of the ACL graft. The surgeon then replaces the damaged ACL with a piece of healthy tissue, usually from part of the kneecap or hamstring tendon. The top and bottom ends of the replacement ligament are fixed with special screws or anchors that are drilled into the bone to properly situate the graft.

Like with any surgical procedure, possible risks that can arise from ACL reconstruction include:


  • Knee pain
  • Knee stiffness
  • Knee weakness
  • Poor healing of the graft
  • Persistent symptoms


After surgery, the patient is allowed to go home later the same day. A few self care measures that are recommended at home include:


  • Using crutches to alleviate pressure on the knee
  • Putting ice on the knee every two hours for at least 20 minutes at a time.
  • Wrapping a compression wrap around the knee
  • Elevating the knee by lying down with the knee propped up on pillows


ACL reconstruction that proves to be a successful surgery, combined with rigorous rehabilitation can restore knee function and stability. Six to nine months after surgery, the patient can regain full range of motion in the knee. Athletes often return to participating in sporting events after six to twelve months. There must be a balance between extreme physical therapy to regain strength and mobility and little workout motivation.