Anterior cruciate ligament (ACL) repair is done to reconstruct the ACL in the knee after it is torn. Often, a graft made of tendon is used to reconstruct the torn ligament.
ACL surgery is an elective procedure. This means that surgery is not always necessary; it may depend on your lifestyle and age.
Surgery may be recommended if you have:
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Smoking may increase the risk of complications and slow healing.
Your doctor may do the following:
Before surgery, you will need to:
You may need to stop taking some medications up to one week before the surgery. Medications that may need to be stopped may include:
Do not eat or drink anything after midnight the day before your surgery, unless told otherwise by your doctor.
Anesthesia will block pain and keep you comfortable during the procedure. Anesthesia methods include:
IVs will be placed in your arm or hands for medications and fluids. The doctor will examine the range of motion of the knee and confirm the ACL tear. Next, the doctor will locate another tendon in your knee or hamstring (called autograft) to reconstruct the torn ligament. Sometimes a donor graft (called allograft) is used. The doctor will form the graft tendon to the correct size.
One or two small keyhole incisions will be made on the top of the knee. An arthroscope (or endoscope) and tiny tools will be inserted into the knee joint. The torn ACL is removed and other damage to the knee is trimmed or repaired. In order to reconstruct the tendon, the doctor will drill holes through bone structures in the thigh and shin. The new graft will be placed through these holes. Needles may be threaded through the holes to suture the new tendon into place. Other devices, such as screws, washers, or staples are also used to hold the graft in place.
Once the graft is securely in place, the doctor will test the knee’s range of motion. Other tests will be done as well. The skin will be closed with stitches. Bandages and/or a brace will be placed on the knee.
About two hours.
Anesthesia will block pain during the procedure. You will have pain after the procedure. Ask your doctor about medication to help manage pain.
This procedure is done in a hospital setting. You can usually go home the same day. If you have complications, you may need to stay longer.
After the procedure, the hospital staff may provide the following care:
When you return home, take these steps:
After arriving home, contact your doctor if any of the following occurs:
If you think you have an emergency, call for medical help right away.
American Academy of Orthopaedic Surgeons
American Orthopaedic Society for Sports Medicine
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
ACL Injury: Does It Require Surgery? American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.a.... Updated September 2009. Accessed May 3, 2013.
Anterior cruciate ligament (ACL) injury. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated April 12, 2013. Accessed May 3, 2013.
Anterior cruciate ligament injuries. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00549. Updated March 2009. Accessed May 3, 2013.
Anterior cruciate ligament injuries: treatment and rehabilitation. Encyclopedia of Sports Medicine and Science website. Available at: http://sportsci.org/encyc/aclinj/aclinj.html. Accessed May 3, 2013.
Canadian Orthopaedic Foundation. Anterior cruciate ligament (ACL) surgery. Canadian Orthopaedic Foundation website. Available at: http://www.canorth.... Accessed May 3, 2013.
Knee ligament repair. John Hopkins Medicine website. Available at. http://www.hopkins.... Accessed May 3, 2013.
6/6/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last reviewed May 2013 by John C. Keel, MD; Brian Randall, MD
Last Updated: 5/3/2013