ACL reconstruction surgery

ACL reconstruction surgery is for patients who have experienced an injury to their anterior cruciate ligament. You might think that ACL tears are only experienced by elite athletes, but this isn’t the case. They usually happen as the result of a twisting motion in the knee. You could injure your ACL by turning or stopping suddenly or landing badly when jumping.

Once the ACL is broken, you might find that your knee feels unstable or ‘gives way’ and this can cause even more damage. Unfortunately, the ACL rarely heals on its own, so surgery to reconstruct it may be the best course of action. Your consultant will discuss all the treatment options with you, including non-surgical interventions.

While you may be keen to get the problem seen to as quickly as possible, if the injury is new, you will need to wait for the swelling to go down before you can have surgery. This can take three weeks from the day of your injury.

Ahead of your surgery, you will also want to strengthen the muscles in your thighs to give your knee the best chance of recovery. Our physiotherapists will show you exercises you can do before and after surgery to support with this.

Technically speaking, the ACL ligament itself can’t be ‘repaired’, but it can be reconstructed using a tissue graft. This is usually taken from your own body, for example from another tendon, such as the patella (kneecap) or the hamstring muscle, so that the ligament is far more likely to be recognised and accepted.

On the day of your surgery, you will be placed under a general anaesthetic. Your surgeon will use a keyhole technique (arthroscopy), which involves inserting a camera through a small incision in the knee. This enables the surgeon to see the torn ligament and use instruments to remove the damaged tissue. Once the area has been cleared, the surgeon secures the graft into position with special screws. The leg is then mobilised so that the surgeon can check the tension in the ligament.

As ACL reconstruction surgery uses a minimally invasive keyhole technique, you are usually able to go home on the same day as your surgery. You will need to arrange for someone to come and collect you, as you won’t be able to drive for at least six weeks.

While patients are usually able to weight-bear straight away, you will be given crutches to support your recovery. You will also be given pain medication and specific advice regarding wound care, including methods for reducing swelling in the knee. In the weeks following your surgery, you may need to return to the hospital to have your stitches removed.

Depending on their progress, patients are typically able to resume the activities or sports they enjoy in around 9 months. For athletes, this can be up to 12 months.

Keyhole surgery is designed to be minimally invasive, but all surgery has risks. For ACL reconstruction surgery, complications can include infection, blood clots, knee pain (behind the kneecap), knee weakness and stiffness.

There is also the risk that your surgery won’t work, which can happen if the graft ligament fails. In this instance, further surgical interventions may be required. Your consultant will discuss all the risks and potential limitations with you ahead of surgery.

You may be covered by private medical insurance, or you may wish to consider spreading the cost of the surgery by opting for a monthly payment plan.

We aim to make our costs as transparent as possible, but it’s important to talk everything through with your consultant at the time of your appointment. Some costs may be paid directly to the hospital, while others, such as your consultant fees, may be paid directly to the consultant.