ACL Reconstruction

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ACL Reconstruction is an operation performed to recreate the ACL(anterior cruciate ligament) using a graft tendon to replace the form and function of the torn ligament. This graft can come from the patient himself, such as a hamstring tendon from the same leg or other leg, patella tendon etc. A second option is to take an allograft from a deceased donor. These allografts are commercially available and cleansed to minimize the risk of disease transmission.

Currently, this operation is usually performed as “key-hole” surgery using a specialized viewing camera and instruments to allow the surgeon to work in the knee joint with small skin incisions. The graft tendon will be positioned in the knee joint through drill holes in the femur and tibia, and fixed in position. In the same sitting, the surgeon will also examine the other knee joint structures such as the cartilage and the menisci for injury, and deal with them appropriately.


Intra-operative pictures showing a torn ACL in the knee


Post-reconstruction picture showing ACL graft in position

What happens after surgery?

This is the time when the athlete’s involvement will determine the success or failure of the surgery. You will need to work closely with your physiotherapist and surgeon in your recovery. The lack of patient participation in the rehabilitation programme is a common cause of poor results and inability to return to sports following ACL surgery.

Immediately after surgery, there will be some pain and swelling in the knee. The initial management is similar to that of an acutely injured knee (see above). Once adequate swelling and pain control has been achieved, the athlete can start on the rehabilitation exercises. There will be various different phases in the programme, with specific emphasis for swelling and pain control, range of motion and muscle strengthening exercises, balancing and agility exercises, and sports-specific drills before you return to your sporting activity of choice.

Everyone recovers from injury and surgery at different rates. Your surgeon and therapist will keep an eye on you to make sure you are making satisfactory progress. Generally, most athletes can return to pivoting and cutting sports about 6 to 9 months after their surgeries.

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Expert Author:
Dr Chong Kian Chun, Island Orthopaedic Consultants

Further Reading

The article above is meant to provide general information and does not replace a doctor's consultation.
Please see your doctor for professional advice.