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Surgery for Anterior Cruciate Ligament (ACL) Injury

The ACL (anterior cruciate ligament) is a band of tough, fibrous tissue that helps stabilize the knee. Injury to this ligament often occurs when the knee is forced beyond its normal range of motion. This can stretch or tear the ligament, much like the fibers of a rope coming apart. Both surgical and nonsurgical treatment has been used to recover from an ACL tear. Several types of surgery are available based on you and your doctor's preferences as well as other factors. Some surgeons will operate soon after an ACL tear, others prefer several weeks of physical therapy first. There are also different anesthesia options available.

Preparing for surgery

  • Stop taking aspirin and other medications 7 days before surgery as advised by your doctor.

  • Arrange to get crutches to use during recovery if your surgeon recommends them.

  • Don’t eat or drink for 10 hours before surgery.

  • Arrange for an adult to drive you home after surgery. 

During surgeryImage of the knee joint showing the ACL graftimage of the knee joint showing a torn ACL

The most common type of surgery for an ACL injury is reconstruction. There are several types of surgeries used:

  • Patellar tendon graft which uses a piece of your own patellar tendon between the knee cap and tibia

  • Quadricepts tendon graft which uses a piece of your own quadriceps tendon between the quadriceps muscle and the knee cap

  • Hamstring tendon graft which uses a piece of your own hamstring tendon between the hamstring muscle and the tibia

  • A cadaver (allograft) tendon graft using any one of several tendons from a cadaver

To rebuild your ACL, your doctor may do open surgery or arthroscopy. During arthroscopy, a a long, thin tube with a tiny camera is inserted into the knee joint so your doctor can see inside the joint. Tools inserted through small incisions are used to repair the joint.

After surgery

  • You’ll spend a few hours in a recovery area. You’ll have ice on your knee to prevent swelling, and your leg may be in a brace.

  • You may receive a continuous cooling machine to relieve swelling and pain.

  • You may receive medications to reduce pain and swelling. Take these as prescribed by your doctor.

  • Depending on the procedure, physical therapy may begin shortly after surgery. This may include light exercises. In some cases, you may use a CPM (continuous passive motion) machine for a time. This machine flexes and extends the knee, keeping it from getting stiff.

  • You can usually go home the same day as surgery. Have an adult family member or friend give you a ride.


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