BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuACL reconstructionAnterior cruciate ligament repair; Knee surgery - ACL; Knee arthroscopy - ACLACL reconstruction is surgery to reconstruct the ligament in the center of your knee. The anterior cruciate ligament (ACL) connects your shin bone (tibia) to your thigh bone (femur). A tear of this ligament can cause your knee to give way during physical activity, most often during side-step or cutting movements.Related video goes here for no-HTML5 browsers Description Most people have general anesthesia for this surgery. This means you will be asleep and pain-free. Other kinds of anesthesia, like regional anesthesia or a block, may also be used for this surgery.General anesthesiaGeneral anesthesia is treatment with certain medicines that puts you into a deep sleep-like state so you do not feel pain during surgery. After you ...Read Article Now Book Mark Article The tissue to replace your damaged ACL will come from your own body or from a donor. A donor is a person who has died and chose to give all or part of their body to help others.Tissue taken from your own body is called an autograft. The most common places to take tissue from are the knee cap tendon, quadriceps tendon, or hamstring tendon. Your hamstrings are the muscles behind your knee. AutograftA bone graft is surgery to place new bone or bone substitutes into spaces around a broken bone or bone defects to stimulate healing.ImageRead Article Now Book Mark Article Tissue taken from a donor is called an allograft or cadaver graft.The procedure is usually performed with the help of knee arthroscopy. With arthroscopy, a tiny camera is inserted into the knee through a small surgical cut. The camera is connected to a video monitor in the operating room. Your surgeon will use the camera to check the ligaments and other tissues of your knee.Knee arthroscopyKnee arthroscopy is surgery that uses a tiny camera to look inside your knee. Small cuts are made to insert the camera and small surgical tools into...ImageRead Article Now Book Mark Article Your surgeon will make other small cuts around your knee and insert other medical instruments. Your surgeon will fix any other damage found, and then will replace your ACL by following these steps:The torn ligament will be removed with a shaver or other instruments. If your own tissue is being used to make your new ACL, your surgeon will make a larger cut. Then, the autograft will be removed through this cut. Your surgeon will make tunnels and sockets in your bone through which to bring the new tissue. This new tissue will be put at the same place as your old ACL. Your surgeon will attach the new ligament to the bone with screws or other devices to hold it in place. As it heals, the graft will remodel to become your new ligament.At the end of the surgery, your surgeon will close your cuts with sutures (stitches) and cover the area with a dressing. You may be able to view pictures after the procedure of what the surgeon saw and what was done during the surgery. Why the Procedure Is Performed If you do not have your torn ACL reconstructed, your knee may continue to be unstable. This increases the chance you may have a meniscus tear. ACL reconstruction may be used for these knee problems:Knee that gives way or feels unstable during daily activities Knee pain Inability to return to sports or other activities When other ligaments are also injured When your meniscus is tornBefore surgery, talk to your health care provider about the time and effort you will need to recover. You will need to follow a rehabilitation program for 4 to 6 months. Your ability to return to full activity will depend on how well you follow the program. Risks The risks from any anesthesia are:Allergic reactions to medicines Allergic reactionsAllergic reactions are sensitivities to substances called allergens that come into contact with the skin, nose, eyes, respiratory tract, and gastroin...ImageRead Article Now Book Mark Article Breathing problemsBreathing problemsBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article The risks from any surgery are:Bleeding BleedingBleeding is the loss of blood. Bleeding may be:Inside the body (internal)Outside the body (external)Bleeding may occur:Inside the body when blood le...ImageRead Article Now Book Mark Article InfectionOther risks from this surgery may include:Blood clot in the leg Blood clotBlood clots are clumps that occur when blood hardens from a liquid to a solid. A blood clot that forms inside one of your veins or arteries is calle...ImageRead Article Now Book Mark Article Failure of the ligament to heal Failure of the surgery to relieve symptoms Injury to a nearby blood vessel Pain in the knee Stiffness of the knee or lost range of motion Weakness of the knee Before the Procedure Always tell your provider what medicines you are taking, even medicines, supplements, or herbs you bought without a prescription.During the 2 weeks before your surgery:You may be asked to stop taking medicines that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin IB), naproxen (Naprosyn, Aleve), and other medicines. Ask your provider which medicines you should still take on the day of your surgery. If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see the provider who treats you for these conditions. DiabetesDiabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.ImageRead Article Now Book Mark Article Heart diseaseCoronary heart disease is a narrowing of the blood vessels that supply blood and oxygen to the heart. Coronary heart disease (CHD) is also called co...ImageRead Article Now Book Mark Article Tell your provider if you have been drinking a lot of alcohol, more than 1 drink per day for women or 2 drinks per day for men. If you smoke, try to stop. Smoking can slow down wound and bone healing. Ask your providers for help if you need it. If you smoke, try to stopThere are many ways to quit smoking. There are also resources to help you. Family members, friends, and co-workers may be supportive. But to be su...ImageRead Article Now Book Mark Article Slow down wound and bone healingQuitting smoking and other nicotine products, including e-cigarettes, before surgery can improve your recovery and outcome after surgery. Most people...ImageRead Article Now Book Mark Article Always let your provider know about any cold, flu, fever, herpes breakout, COVID-19, or other illnesses you may have before your surgery.ColdThe common cold most often causes a runny nose, nasal congestion, and sneezing. You may also have a sore throat, cough, headache, or other symptoms....ImageRead Article Now Book Mark Article FluThe flu (influenza) is a viral respiratory illness that causes fever, chills, runny nose, body aches, and cough. It spreads easily from person to pe...ImageRead Article Now Book Mark Article COVID-19Coronavirus disease 2019 (COVID-19) is a respiratory illness that causes fever, coughing, and shortness of breath, but many other symptoms can occur....ImageRead Article Now Book Mark Article On the day of your surgery:You will often be asked not to drink or eat anything for 6 to 12 hours before the procedure. Take the medicines you have been told to take with a small sip of water. You will be told when to arrive at the hospital. After the Procedure Most people can go home the day of the surgery. You may have to wear a knee brace for the first 1 to 6 weeks. You also may need crutches for 1 to 6 weeks. How long you will need to use a crutch and brace will depend on the type of surgery you had and the extent of the reconstruction. Most people are allowed to move their knee right after surgery. This may help prevent stiffness. You may need medicine for your pain.CrutchesIt is important to start walking as soon as you can after your surgery. But you will need support for walking while your leg heals. Crutches may be...Read Article Now Book Mark Article Physical therapy can help many people regain motion and strength in their knee. Therapy can last up to 4 to 6 months.How soon you return to work will depend on the kind of work you do. It can be from a few days to a few months. A full return to activities and sports will often take 4 to 6 months. Sports that involve quick changes in direction, such as soccer, basketball, and football, may require up to 9 to 12 months of rehabilitation. Outlook (Prognosis) Most people will have a stable knee that does not give way after ACL reconstruction. Better surgical methods and rehabilitation have led to:Less pain and stiffness after surgery Fewer complications with the surgery itself Faster recovery timeOpen ReferencesReferencesCheung EC, McAllister DR, Petrigliano FA. Anterior cruciate ligament injuries. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 98.Lamplot JD, Bogunovic L, Wright RW. Revision anterior cruciate ligament injuries. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 99.Miller RH, Azar FM. Knee Injuries. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 45.Phillips BB, Mihalko MJ. Arthroscopy of the lower extremity. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 51.AllVideoImagesTogAnterior cruciate ligament repair - seriesPresentation Anterior cruciate ligament repair - seriesPresentation Related Information Knee arthroscopy(Surgery)Anterior cruciate ligament (ACL) injury(Injury)Knee pain(Symptoms)Knee MRI scan(Medical Test)Surgical wound care - open(Self-Care)Getting your home ready - knee or hip surgery(Self-Care)ACL reconstruction - discharge (Discharge) Review Date: 6/4/2025 Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. 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ACL reconstructionAnterior cruciate ligament repair; Knee surgery - ACL; Knee arthroscopy - ACLACL reconstruction is surgery to reconstruct the ligament in the center of your knee. The anterior cruciate ligament (ACL) connects your shin bone (tibia) to your thigh bone (femur). A tear of this ligament can cause your knee to give way during physical activity, most often during side-step or cutting movements.Related video goes here for no-HTML5 browsers Description Most people have general anesthesia for this surgery. This means you will be asleep and pain-free. Other kinds of anesthesia, like regional anesthesia or a block, may also be used for this surgery.General anesthesiaGeneral anesthesia is treatment with certain medicines that puts you into a deep sleep-like state so you do not feel pain during surgery. After you ...Read Article Now Book Mark Article The tissue to replace your damaged ACL will come from your own body or from a donor. A donor is a person who has died and chose to give all or part of their body to help others.Tissue taken from your own body is called an autograft. The most common places to take tissue from are the knee cap tendon, quadriceps tendon, or hamstring tendon. Your hamstrings are the muscles behind your knee. AutograftA bone graft is surgery to place new bone or bone substitutes into spaces around a broken bone or bone defects to stimulate healing.ImageRead Article Now Book Mark Article Tissue taken from a donor is called an allograft or cadaver graft.The procedure is usually performed with the help of knee arthroscopy. With arthroscopy, a tiny camera is inserted into the knee through a small surgical cut. The camera is connected to a video monitor in the operating room. Your surgeon will use the camera to check the ligaments and other tissues of your knee.Knee arthroscopyKnee arthroscopy is surgery that uses a tiny camera to look inside your knee. Small cuts are made to insert the camera and small surgical tools into...ImageRead Article Now Book Mark Article Your surgeon will make other small cuts around your knee and insert other medical instruments. Your surgeon will fix any other damage found, and then will replace your ACL by following these steps:The torn ligament will be removed with a shaver or other instruments. If your own tissue is being used to make your new ACL, your surgeon will make a larger cut. Then, the autograft will be removed through this cut. Your surgeon will make tunnels and sockets in your bone through which to bring the new tissue. This new tissue will be put at the same place as your old ACL. Your surgeon will attach the new ligament to the bone with screws or other devices to hold it in place. As it heals, the graft will remodel to become your new ligament.At the end of the surgery, your surgeon will close your cuts with sutures (stitches) and cover the area with a dressing. You may be able to view pictures after the procedure of what the surgeon saw and what was done during the surgery. Why the Procedure Is Performed If you do not have your torn ACL reconstructed, your knee may continue to be unstable. This increases the chance you may have a meniscus tear. ACL reconstruction may be used for these knee problems:Knee that gives way or feels unstable during daily activities Knee pain Inability to return to sports or other activities When other ligaments are also injured When your meniscus is tornBefore surgery, talk to your health care provider about the time and effort you will need to recover. You will need to follow a rehabilitation program for 4 to 6 months. Your ability to return to full activity will depend on how well you follow the program. Risks The risks from any anesthesia are:Allergic reactions to medicines Allergic reactionsAllergic reactions are sensitivities to substances called allergens that come into contact with the skin, nose, eyes, respiratory tract, and gastroin...ImageRead Article Now Book Mark Article Breathing problemsBreathing problemsBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article The risks from any surgery are:Bleeding BleedingBleeding is the loss of blood. Bleeding may be:Inside the body (internal)Outside the body (external)Bleeding may occur:Inside the body when blood le...ImageRead Article Now Book Mark Article InfectionOther risks from this surgery may include:Blood clot in the leg Blood clotBlood clots are clumps that occur when blood hardens from a liquid to a solid. A blood clot that forms inside one of your veins or arteries is calle...ImageRead Article Now Book Mark Article Failure of the ligament to heal Failure of the surgery to relieve symptoms Injury to a nearby blood vessel Pain in the knee Stiffness of the knee or lost range of motion Weakness of the knee Before the Procedure Always tell your provider what medicines you are taking, even medicines, supplements, or herbs you bought without a prescription.During the 2 weeks before your surgery:You may be asked to stop taking medicines that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin IB), naproxen (Naprosyn, Aleve), and other medicines. Ask your provider which medicines you should still take on the day of your surgery. If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see the provider who treats you for these conditions. DiabetesDiabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.ImageRead Article Now Book Mark Article Heart diseaseCoronary heart disease is a narrowing of the blood vessels that supply blood and oxygen to the heart. Coronary heart disease (CHD) is also called co...ImageRead Article Now Book Mark Article Tell your provider if you have been drinking a lot of alcohol, more than 1 drink per day for women or 2 drinks per day for men. If you smoke, try to stop. Smoking can slow down wound and bone healing. Ask your providers for help if you need it. If you smoke, try to stopThere are many ways to quit smoking. There are also resources to help you. Family members, friends, and co-workers may be supportive. But to be su...ImageRead Article Now Book Mark Article Slow down wound and bone healingQuitting smoking and other nicotine products, including e-cigarettes, before surgery can improve your recovery and outcome after surgery. Most people...ImageRead Article Now Book Mark Article Always let your provider know about any cold, flu, fever, herpes breakout, COVID-19, or other illnesses you may have before your surgery.ColdThe common cold most often causes a runny nose, nasal congestion, and sneezing. You may also have a sore throat, cough, headache, or other symptoms....ImageRead Article Now Book Mark Article FluThe flu (influenza) is a viral respiratory illness that causes fever, chills, runny nose, body aches, and cough. It spreads easily from person to pe...ImageRead Article Now Book Mark Article COVID-19Coronavirus disease 2019 (COVID-19) is a respiratory illness that causes fever, coughing, and shortness of breath, but many other symptoms can occur....ImageRead Article Now Book Mark Article On the day of your surgery:You will often be asked not to drink or eat anything for 6 to 12 hours before the procedure. Take the medicines you have been told to take with a small sip of water. You will be told when to arrive at the hospital. After the Procedure Most people can go home the day of the surgery. You may have to wear a knee brace for the first 1 to 6 weeks. You also may need crutches for 1 to 6 weeks. How long you will need to use a crutch and brace will depend on the type of surgery you had and the extent of the reconstruction. Most people are allowed to move their knee right after surgery. This may help prevent stiffness. You may need medicine for your pain.CrutchesIt is important to start walking as soon as you can after your surgery. But you will need support for walking while your leg heals. Crutches may be...Read Article Now Book Mark Article Physical therapy can help many people regain motion and strength in their knee. Therapy can last up to 4 to 6 months.How soon you return to work will depend on the kind of work you do. It can be from a few days to a few months. A full return to activities and sports will often take 4 to 6 months. Sports that involve quick changes in direction, such as soccer, basketball, and football, may require up to 9 to 12 months of rehabilitation. Outlook (Prognosis) Most people will have a stable knee that does not give way after ACL reconstruction. Better surgical methods and rehabilitation have led to:Less pain and stiffness after surgery Fewer complications with the surgery itself Faster recovery timeOpen ReferencesReferencesCheung EC, McAllister DR, Petrigliano FA. Anterior cruciate ligament injuries. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 98.Lamplot JD, Bogunovic L, Wright RW. Revision anterior cruciate ligament injuries. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 99.Miller RH, Azar FM. Knee Injuries. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 45.Phillips BB, Mihalko MJ. Arthroscopy of the lower extremity. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 51.
