Knee surgery (ACL repair)

What is the anterior cruciate ligament?

The anterior cruciate ligament (ACL) is one of the important ligaments that stabilise your knee joint. If you have torn (ruptured) this ligament, the knee can collapse or ‘give way’ when making twisting or turning movements.

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 happens during ACL reconstruction?

ACL reconstruction is normally performed under general anaesthetic. The operation usually takes between an hour and an hour and a half. Your surgeon will make one or more cuts on the front and sides of 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 (a graft) from elsewhere in the body (usually hamstring tendons). The top and bottom ends of the replacement ligament are fixed with special screws or anchors into ‘tunnels’ drilled in the bone.

How soon will I recover?

You should be able to go home the same day or the day after. Before you are discharged a physiotherapist will give you gentle exercises to help in your recovery.

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 regular physiotherapy treatment that may continue for as long as six months. Complete recovery can take up to nine 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.

Most people make a good recovery and return to normal activities following ACL reconstruction. As with any surgery, there can be complications.

General complications of any operation:

• Pain
• Bleeding
• Infection in the surgical wound
• Unsightly scarring
• Blood clots (DVT)
• Difficulty passing urine
  

Specific complications of ACL reconstruction:

• 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
• Recurrent giving way of the knee
• Severe pain, stiffness and loss of use of the knee (Complex Regional Pain Syndrome)