Understanding Anterior Cruciate Ligament (ACL) Reconstruction: A Path to Regaining Knee Stability
Injuries to the knee can have life-changing effects, particularly for those who are highly physically active. One of the most commonly injured structures is the anterior cruciate ligament (ACL), an integral part of the knee that helps to maintain its stability. When the ACL tears, usually during sports or other high-impact activities, patients can suffer from pain, swelling, instability, and an inability to move their leg.
For some patients, ACL reconstructive surgery may provide an opportunity to regain normal function of the knee and get back to daily activities or sports. In this blog, we dive into what an ACL reconstruction is, who may need one, and what to expect as you recover. If you’re thinking about the treatment, knowing the procedure is the first step toward making an informed decision.
What is the ACL and Why Is It Important?
The anterior cruciate ligament is one of four main ligaments in the knee. It crosses diagonally across the middle of the knee joint, connecting your thigh bone (femur) to the shinbone (tibia). It works primarily to avoid anterior tibial glide and for rotary stability.
They tend to happen when you come to a sudden stop, twist, or change direction — things that happen regularly in sports such as football, rugby, skiing, or basketball. The ACL does not heal on its own once it is torn because it has poor blood supply, and surgical reconstruction is the best way to restore knee function.
Who Needs ACL Reconstruction?
Surgery is not necessary for all ACL injuries. Setting and plan: For mild sprains or partial tears (less than 20% disruption), treatment with physiotherapy and activity modification may be appropriate. But full tears — particularly in younger or active patients — often require repair to regain full function and prevent long-term injuries, such as cartilage wear or meniscus injuries.
Reasons for an operation: Operation is typically advised if:
- Your knee gives out during normal activity or during exercise
- You want to go back to doing high-demand activities
- You have mixed injuries (i.e., ACL tear and meniscus lesion)
- The conservative therapy didn’t have the intended effect
What Does the Procedure Involve?
The reconstructive surgery for the ACL is usually arthroscopic (minimally invasive). The damaged ligament is replaced, and the tissue graft serves as a bridge for new ligament tissue to grow on. The graft can come from:
- Your own tissues (autograft), most commonly the patellar tendon, hamstring tendon, or quadriceps tendon
- A donor (allograft), in some instances
Depending on the status of the ligament, damaged tissue is either resected or preserved. The new graft is used to hold the bone in two small holes drilled through the femur and tibia, and is secured using screws or other techniques of fixation.
This is a very specialist procedure, which typically takes anywhere from 1 to 1.5 hours and is usually performed as a day case under a general or spinal anaesthetic.
Recovery and Rehabilitation
Successful ACL reconstruction relies heavily on post-operative rehabilitation. Recovery time can vary, but most patients return to light activities within a few weeks and sports within six to nine months, depending on progress.
A structured physiotherapy programme focuses on:
- Reducing swelling and regaining range of motion
- Strengthening surrounding muscles, especially the quadriceps and hamstrings
- Restoring balance and joint stability
- Gradually returning to sport-specific movements
Following your surgeon and physiotherapist’s guidance is crucial for avoiding setbacks and achieving the best outcome.
Risks and Complications
As with any surgery, there are risks to ACL reconstruction. These may include:
- Infection
- Blood clots
- Graft failure or re-injury
- Tightness or lack of flexibility
- Knee pain or weakness
However, complications are rare, particularly when the surgery is carried out by experienced specialists and followed by appropriate rehabilitation.
Is ACL Reconstruction Right for You?
The decision to have ACL reconstruction is individual and will depend on your age, activity level, general health, and aspirations. Although some people can manage without surgery, others may struggle long-term without an ACL, especially active individuals involved in sport or physical work, where surgery is the best solution.
A detailed discussion with an orthopaedic expert will be required before deciding. They will be able to assess the severity of your injury on imaging (for example, MRI), talk through the possible treatment options, and guide you through recovery.
Conclusion
Anterior cruciate ligament reconstruction provides a solution for individuals with a torn ACL who wish to regain knee stability, functionality, and confidence. Whether you are an athlete or simply tired of daily knee instability, this treatment aims to restore your desired activity level while preventing future joint damage.
If you’re considering ACL reconstruction or want to explore treatment options after a knee injury, book an appointment with our specialists today. We’re here to guide you through every step of your recovery journey.
Chase Lodge Hospital
To learn more, visit: Mayo Clinic – ACL Reconstruction
