Anterior Cruciate Ligament (ACL) Reconstruction
Anterior Cruciate Ligament (ACL) reconstruction surgery is a procedure used to rebuild a torn ligament in the knee using a tendon graft. The ACL is one of the knee’s main stabilising ligaments and when torn, it can cause instability and the feeling that the knee may give way.
During the procedure, the damaged ligament is replaced with a tendon graft taken either from another part of your body or from a donor. Over time, the graft develops into a new ligament, helping to restore stability and knee function.
Following ACL reconstruction surgery, you will work closely with physiotherapists to rebuild strength, movement and stability in the knee. Recovery is longer than ACL repair surgery because the graft needs time to heal and integrate fully.
Who is a Candidate?
- Patients with a complete or severe ACL tear, typically confirmed by MRI or clinical examination
- Usually those experiencing significant knee instability, repeated giving-way episodes or inability to return to physical activity
- Often younger or active patients, particularly those involved in sport, manual work or pivoting activities
- Patients whose ACL is not suitable for direct repair due to the location or extent of the tear.
Recovery Timeline
Will vary with provider
- Hospital stay: Often day surgery or a 1-night hospital stay
- Early recovery: Weight-bearing usually begins with crutches and sometimes a knee brace
- Rehabilitation: Physiotherapy typically starts within days of surgery to restore movement and reduce swelling
- Return to daily activities: Usually around 4–8 weeks depending on progress
- Return to sport: Often 9–12 months depending on graft healing, strength recovery and rehabilitation progress.
Benefits
- Restores stability to the knee joint
- Supports return to sport and higher-demand physical activities
- Reduces the risk of further meniscus or cartilage damage caused by instability
- Improves confidence, mobility and knee function over the long term.
Risks
- Surgical risks including infection, blood clots, bleeding or nerve injury
- Graft failure, stretching or re-rupture
- Knee stiffness or reduced range of movement
- Persistent pain, swelling or instability
- Donor site discomfort if your own tendon is used for the graft.
This is just an outline. Your specialist orthopaedic surgeon will be able to talk to you about these issues in more detail and make sure that there is informed consent.