Anterior cruciate ligament (ACL) repair

Anterior cruciate ligament (ACL) repair surgery is a procedure used to preserve and reattach your natural ACL after it has been torn. Unlike ACL reconstruction surgery, which replaces the ligament with a tendon graft, ACL repair focuses on repairing the existing ligament tissue.

ACL repair is only suitable for certain tears where the ligament tissue remains healthy enough to heal. During the procedure, the surgeon reattaches the torn ligament to the bone using specialised fixation techniques. Because the original ligament is preserved, recovery can sometimes be faster than ACL reconstruction surgery.

Following ACL repair surgery, you will work with physiotherapists to restore strength, movement and knee stability, helping you return safely to normal activities and sport.

Who is a Candidate?

• Patients with a recent ACL tear where the ligament tissue is still healthy and repairable
• Usually tears located near where the ligament attaches to the bone
• Patients experiencing knee instability or giving-way episodes
• Often younger or active patients, although suitability depends mainly on the tear pattern and tissue quality rather than age alone.

Recovery Timeline

Will vary with provider.

• Hospital stay: Often day surgery or a 1-night hospital stay
• Early recovery: Weight-bearing may begin immediately or shortly after surgery, often with crutches or a brace
• Rehabilitation: Physiotherapy usually begins within days to restore movement and reduce swelling
• Return to daily activities: Often within 4–6 weeks depending on recovery progress
• Return to sport: Commonly around 6–9 months depending on healing, strength and knee stability.

Benefits

• Preserves the patient’s natural ACL tissue
• Avoids the need for a tendon graft
• Potentially shorter recovery and rehabilitation compared with ACL reconstruction
• Restores knee stability and function
• May reduce pain or complications associated with graft harvesting.

Risks

• Surgical risks including infection, bleeding, blood clots or nerve injury
• Failure of the repaired ligament to heal properly
• Persistent instability or re-tear
• Knee stiffness or reduced range of movement
• Ongoing pain or swelling.

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.