Surgical Information

Anterior Cruciate Ligament (ACL) Reconstruction

What is ACL reconstruction?

ACL reconstruction is surgery to rebuild the ligament in the center of the knee with a new ligament.

Most ACL reconstruction is performed using knee arthroscopy. In this minimally invasive procedure, the surgeon makes several small incisions around the knee joint and inserts a narrow fiber optic scope (called an arthroscope) to examine the condition of the knee. Tiny instruments are used to remove the damaged ligament and replace it with a graft. Tunnels are drilled into your femur (thighbone) and tibia (shinbone) to accurately position the graft, which is then anchored with screws or other fixation devices.

ACL reconstruction surgery uses an autograft (tissue from your body) or an allograft (tissue from a cadaver) to replace the ligament. The autograft method is typically most successful in patients who want to return to a high-demand, athletic lifestyle. As patients get older, and demands diminish, the success of the allograft procedure increases. Ultimately, it depends on the unique needs of each individual. Different techniques work best in different situations.


The ACL is one of the four major ligaments of the knee. It runs diagonally in the middle of the knee and connects the back of the femur to the front of the tibia. The ACL helps stabilizes the knee joint and keep it from rotating.

ACL tears are one of the most common knee ligament injuries. They range from mild, small tears, to severe tears when the ligament and part of the bone separate from the rest of the bone. Most ACL injuries are complete or near-complete tears. A torn ACL can cause your knee to give way during physical activity.


When is surgery recommended?

Not all ACL tears require surgery. Initial treatment focuses on pain control and restoring range of motion. It is important to regain motion in the knee as soon as possible to prevent permanent damage.

Surgery depends on several factors including a patient’s age, activity level, severity of symptoms and expectations. For older patients who are stable, with little desire to return to high-level sports or fitness routines, non-operative rehabilitation and activity modification may be sufficient. For active patients – young athletes especially – reconstruction is highly recommended. Strong knees are crucial for returning to sports and preventing re-injury.


What is the recovery time?

Surgical recovery varies by patient. It usually takes from four to six months to rebuild adequate strength and range of motion in your knee. At that point, you can resume light exercise, such as walking or jogging, and other activities.

Patients should wait from eight to 12 months before returning to aggressive contact sports. Proper rehabilitation is critical for the vascular structure to strengthen and the graft to get strong. Athletes who resume cutting and pivoting sports too soon risk re-injury.

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