Anterior Cruciate Ligament Reconstruction
This webpage will give you information about an ACL
reconstruction. If you have any questions, you should ask your GP
or other relevant health professional.
What is the anterior cruciate ligament?
The anterior cruciate ligament (ACL) is one of the important
ligaments that stabilise the knee joint (see figure 1). If this
ligament has been torn (ruptured), the knee can collapse or ‘give
way’ when making twisting or turning movements.
Figure 1 - Diagram showing the internal structure of a
right knee
How does an ACL rupture happen?
An ACL rupture happens as a result of a twisting injury to the
knee. The common causes are football and skiing injuries. You can
injure other parts of your knee at the same time, such as tearing a
cartilage or damaging the joint surface.
What are the benefits of surgery?
If your ACL reconstruction is successful, your knee should not
give way any more. This will allow you to be more active and return
to some or all of your sporting activities.
Are there any alternatives to surgery?
Your physiotherapist can give you exercises to strengthen and
improve the co-ordination of the muscles in your thigh. This can
often stop your knee giving way during everyday activities. Wearing
a knee brace can sometimes help during sports activities.
What does the operation involve?
A variety of anaesthetic techniques are possible. The operation
usually takes between an hour and an hour and a half.
Your surgeon will make one or more cuts around your knee. Some
surgeons perform the operation by arthroscopy (‘keyhole’ surgery)
using a camera to see inside the knee.
Your surgeon will replace the ACL with a piece of suitable
tissue from elsewhere in the body. The ends of the replacement
ligament are fixed with special screws or anchors into ‘tunnels’
drilled in the bone.
What complications can happen?
1 General complications
- Pain
- Bleeding
- Infection in the surgical site (wound)
- Unsightly scarring
- Blood clots
- Difficulty passing urine
2 Specific complications
- Break of the kneecap
- Damage to nerves around the knee
- Infection in the knee joint
- Discomfort in the front of the knee
- Loss of knee movement
- The knee keeps giving way
- Severe pain, stiffness and loss of use of the knee (Complex
Regional Pain Syndrome)
How soon will I recover?
You should be able to go home the same day or the day after.
Your surgeon may want you to wear a knee brace for a few weeks
after the operation. Once your knee is settling down you will need
to start intensive physiotherapy treatment which may continue for
as long as six months.
Regular exercise should help you to return to normal activities
as soon as possible. Before you start exercising, you should ask a
member of the healthcare team or your GP for advice.
It is unlikely that your knee will ever be quite as good as it
was before the original injury.
Summary
If your knee continually gives way after an ACL rupture,
reconstruction offers the chance of improving the stability of your
knee in everyday life and in sporting activities. You may be able
to return to a level of sport that otherwise would not be
possible.
Acknowledgements
Author: Mr Stephen Milner DM FRCS (Tr. & Orth.)
Illustrations: Medical Illustration Copyright © 2010 Nucleus
Medical Art. All rights reserved. www.nucleusinc.com
This document is intended for information purposes only and
should not replace advice that your relevant health professional
would give you.
Copyright © 2011 EIDO Healthcare Limited
The operation and treatment information on this website is produced
by EIDO Healthcare Ltd and is licensed by Ramsay Health Care
UK. The intellectual property rights to the information belong
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You may not copy, print out, download or otherwise reproduce any
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The information should not replace advice that your relevant
health professional would give you.