ACL Reconstruction

Arthroscopic-assisted ACL reconstruction is the gold standard surgery to treat a complete ACL rupture (tear) in young, active patients. It is a minimally invasive surgical procedure using a camera and small incisions to rebuild a torn ACL with a tissue graft, either made of the patient’s tendon (an autograft) or a donor ligament or tendon (allograft), to restore knee stability and function. Reconstruction restores normal biomechanical knee function and allows a return to sports and activity.

ACL reconstruction is considered when the ACL is completely torn, the patient experiences knee instability with cutting—or pivoting-type activities that interfere with daily activities or the demands of their job, sport, or other physical activities, and conservative treatments such as physical therapy and bracing have failed to restore knee stability.

Prehabilitation is the phase prior to ACL surgery. It is valuable for preparing the patient for surgery and recovery and helps optimize outcomes following surgery. The goal is to alleviate pain and swelling, regain muscle strength (especially in the quadriceps muscle group), and restore the knee range of motion.

Minimally invasive ACL reconstruction is an outpatient procedure performed under general and regional anesthesia. The procedure is performed through small incisions around the knee joint, using an arthroscope—a specialized camera—to visualize the internal structure of the knee on a monitor. This allows the surgeon to perform the surgery with high precision while minimizing trauma to the surrounding tissues. Tiny surgical tools are inserted into the small incisions to remove the damaged ACL tissue and assess the rest of the knee for injury, including the cartilage and meniscus.

The ACL graft is selected and prepared to replace the torn ACL. Small tunnels are drilled into the thigh and shin bones to attach the graft to the knee. The graft is positioned in place of the original ACL and is threaded through the prepared tunnels. The graft is then secured to the bone with screws or other fixation devices to allow it to integrate into the bones. Your surgeon will test the knee’s range of motion and graft security. The tiny incisions are closed, and the knee is placed into a stabilizing brace. The patient goes home the same day with crutches.

A specialized rehabilitation plan reduces swelling and pain and restores stability and function to prevent re-injury. Physical therapy typically starts at week one and involves weekly visits for at least several months. Progressive physical therapy is essential to healing and restoring function. Athletes may require up to 12 months to heal before returning to contact or cutting/pivoting sports.

The goal of treatment is to restore healthy knee function, prevent future injury, and maintain the long-term health of the knee joint, potentially delaying or preventing the development of knee osteoarthritis.