ACL reconstructive surgery is an outpatient surgery, which means that you can go home the same day — although you will need to arrange a lift home from the hospital.
The surgery takes between 1–2 hours, and you will be under general anaesthesia, so you will be unconscious, and you will not feel any pain during the procedure.
ACL surgery can be done in various ways, but the most effective method is reconstructing your ACL ligament with a piece of your tendon, a band of tissue that connects your muscle to a bone. This tendon is called a graft and functions as the new ACL.
What types of grafts are used?
A graft taken from your own body is called an autograft. A graft taken from a donor (someone who has given permission for their organs to be donated after their death) is called an allograft.
Autografts can be sourced from various places:
- Hamstring – the back of the thing
- Quadricep – front of the thigh
- Patellar tendon – the tendon that holds the knee cap (the patella) in place
Your surgeon will discuss details of the surgery, graft options and post-surgery rehabilitation.
How is ACL surgery performed?
The procedure is performed using a technique called knee arthroscopy, which is more commonly known as keyhole surgery.
This means that your orthopaedic surgeon will make small cuts in your knee and pass an arthroscope (a thin, metal tube with a light and camera at the end) into your joint. Your surgeon will use the attached monitor to clearly see inside your joint and determine the extent of your injury and if any other repair work to other ligaments, such as repairing the meniscus, needs to be done.
After harvesting the graft, the surgeon will drill two bone tunnels — one in your tibia and another in your femur, and thread the graft through. Your surgeon will then fix the tendon into place with screws and/or metal buttons, which will remain in your knee permanently.
Your surgeon will also repair any other structures of the knee, such as ligaments or meniscus tears, before closing your incisions with stitches. You will be given pain relief and a local anaesthetic to alleviate pain upon waking.
Once conscious, you will start physio the same day before being discharged to go home.