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ACL reconstruction surgery

Anterior cruciate ligament (ACL) surgery repairs and reconstructs your damaged ligament, helping you get back to life without pain

Doctor holds a model of a knee to explain ACL reconstruction surgery
ACL reconstruction surgery is a type of knee surgery that involves repairing or reconstructing your anterior cruciate ligament (ACL). This can be done using a number of different methods.

The ACL is a tough band of tissue in your knee joint that joins your thigh bone to your shin bone. It runs diagonally through the inside of your knee, helping to control the back-and-forth movement of your lower leg and to stabilise your knee joint. If you have a torn ACL, you might struggle to put weight on on your knee, making walking and balancing a challenge.

What is orthopaedic surgery?

If you need ACL reconstruction surgery for a torn ACL, the procedure will be performed by one of our orthopaedic consultants. Orthopaedic surgery is focused on the treatment of injuries and disorders of your joints and their associated soft tissues (your ligaments, nerves and muscles). These components make up your musculoskeletal system, which supports and protects your movement and muscular health, among other things.

There are many factors that can cause damage to your musculoskeletal system, causing pain and swelling in turn. The most common are traumatic injuries (often incurred during contact sport), and degenerative joint conditions such as arthritis, which cause deterioration over time. Joint pain can be experienced as widespread pain throughout your body, but it is more often localised in one or perhaps two joints.

If you have a torn ACL that has impacted your balance and mobility, you would benefit from reconstructive surgery. At Circle Health Group, we have a network of dedicated consultant orthopaedic surgeons who are ready and waiting to help you. Together we'll find a way to resolve your knee pain.

To find out more about our services, you can book an appointment online today or call us on 0141 300 5009.

Knee ligament repair (ACL) surgery cost

Please be aware that the following prices are a guide price. Your final price will be confirmed in writing following your consultation and any necessary diagnostic tests.

Patient pathway Initial consultation Diagnostic Investigations Main treatment Post discharge care Guide price
Hospital fees N/A Not included £7,475 Included £7,475
Consultants fees from £200 N/A Included Included £200
Guide price £7,675

ACL injuries are one of the most common types of knee injuries. They usually occur when playing sport, such as football, rugby, tennis, and squash. They happen if your lower leg extends forward too much, or if your knee and lower leg are twisted. If your ACL is torn, your knee may become unstable and lose its full range of movement, making it difficult to play sport. The injury can also cause significant pain and swelling in your knee.

If you experience any of the following symptoms, you may have injured your ACL:

  • Knee pain and swelling
  • Difficulty when walking
  • Hearing a loud "pop" in your knee and experiencing severe pain afterwards
  • The loss of a full range of movement in your knee
  • Difficulty when straightening your knee

The decision to have knee surgery depends on how damaged your ACL is. If the injury is painful and affecting your lifestyle (preventing you from moving, balancing, or playing sport) you might need surgery. If your knee feels stable and you do not have an active lifestyle, you might decide not to have ACL surgery. But delaying surgery could cause further damage to your knee, so it is important to discuss surgery and whether your need it with your doctor. They'll help you decide whether ACL reconstruction surgery is the right procedure for you.

Your initial consultation is a very important part of your treatment journey. It's when we first get to know you and we use it to make a diagnosis. You should feel free to ask as many questions as you like along the way, because it's just as important for you as it is for us. 

If you have a known or suspected anterior cruciate ligament injury, your consultant will start by asking you a series of questions about your injury and your symptoms, for example when you hurt your knee and how, and how it affects you. They will also take a detailed medical history, they'll ask whether you're currently taking any medications, and they'll ask about any treatment you might already have had that relates to your ACL injury.

During this consultation, your specialist will probably make a short physical examination of your knee, and if necessary they will book you in for further tests (for example an X-ray) to help them be sure of their diagnosis. One of our radiographers will likely perform these tests, and if we can't do them on the day we'll invite you back another day. 

Once your consultant is happy with their diagnosis of your knee problem, they will explain the issue to you in more detail and talk you through the available treatment problems. We build our treatment plans around the individual, so we always want to get your input before we make decisions. The right choice for you will depend on your personal circumstances as well as what you want to get from surgery. For example, if you are a keen sportsman, you might be looking for the quickest possible recovery. 

Once you've decided on the right course of treatment for you, we'll put together a fixed price package so that you know exactly what you'll pay ahead of time. If you're happy with this, we can get your treatment booked in. 

Your doctor might ask you to fast for a short period of time before having ACL reconstruction surgery, because you usually need an empty stomach during surgery (so you do not vomit while you're under anaesthetic). They might also ask that you stop taking certain medications before the operation.

Eating healthily and staying as active as possible before surgery helps maintain your overall health and fitness, ensuring you recover as quickly as possible. This does not need to be strenuous exercise (which could further damage your knee). Gentle walking and stretching regularly before surgery should be enough. Your consultant or physiotherapist will let you know what to do.

You'll need to arrange for someone to pick you up from hospital after surgery, because you won't be able to drive yourself after having anaesthetic. If you'd rather, we can arrange for a taxi to take you home. 

Your consultant will make sure you know ahead of time exactly how to prepare for surgery and what to expect when you come into hospital.

ACL reconstruction surgery can be carried out in a number of ways. The most common method involves removing and replacing your torn ligament with a tendon (a band of tissue that usually connects your muscle to your bone). This replacement tendon, which is also known as a graft, is either taken from another part of your knee or from a donor. 

This procedure is performed using a technique called knee arthroscopy, which is also known as keyhole surgery. Knee arthroscopy is done by making small incisions (cuts) into your knee joint, through which your surgeon passes an arthroscope (a thin, metal tube with a light and camera at one end). This is attached to a monitor, which allows your consultant to clearly see the inside of your knee, allowing them to perform the repair without having to 'open up' your knee, watching what's happening on the monitor in real time.

How is ACL reconstruction performed?

You'll either have a general anaesthetic (which means you'll be unconscious during the procedure), or a spinal anaesthetic (when anaesthetic is injected into your spine so you're conscious but unable to feel anything).

Your consultant will ensure you know which kind of anaesthetic you will be getting before the procedure.

Your consultant will begin by making one or more small cuts on the front and sides of your knee. Through these, they will insert the arthroscope, as well as specially designed surgical tools.

These are used to remove your damaged ligament and replace it with a segment of tendon (graft). Your surgeon will drill sockets into your thighbone and shinbone to accurately position the graft, which is fixed to your bones with special screws. The graft will serve as surface on which new ligament tissue can grow.

Your consultant will close the wound with stitches or surgical clips. If the stitches are dissolvable, they will disappear after around three weeks.

ACL reconstruction surgery typically takes between an hour and an hour and a half.

The different kinds of graft tissue used during surgery

There are many different tissues that can replace your ACL. Tissue taken from your own body is called an autograft. Tissue taken from a donor is called an allograft. 

Tissues that can replace your ACL include:

Your patellar tendon

This tendon runs from your bottom of  kneecap (patella) to the top of your shin bone (tibia) at the front of your knee.

Your hamstring tendon 

This runs from the back of your knee on the inner side of your leg, all the way up to your thigh.

Your quadriceps tendon

This is the tendon that attaches your patella to your quadriceps muscle, which is the large muscle on the front of your thigh.

Every individual's ACL recovery timeline looks slightly different. The factors that will affect your personal recovery include:

  • How fit you were before having the procedure
  • Your usual everyday activities
  • The nature of your job
  • Your age

Your orthopaedic surgeon will understand your personal circumstances better and be able to advise what your specific recovery timeline looks like.

One to two days after surgery

You will be encouraged to move your knee as soon as you can after surgery. You might experience some pain and discomfort in your knee as the anaesthetic eases. This can be managed with painkillers, which your nurse will be able to give you.

Your physiotherapist will be there to help you get out of bed and take your first steps following the operation. You might be offered crutches or a walker to help support your knee as you bear weight on your leg. If your stitches are not dissolvable, you will have a follow-up appointment to remove them. 

Most people can leave hospital about 24 hours after surgery, but you won't be able to drive for a while, so we recommend you ask a friend or family member to come and collect you. Or of course you can go home in a taxi if you would prefer, and we'll be happy to arrange one for you. 

Two to six weeks after surgery

Your knee will likely be painful and swollen for up to two weeks after surgery, but this can continue to be managed at home with painkillers. Your consultant will advise that you keep your leg raised as much as possible at home. We suggest placing pillows under your foot when you're in bed. You can also use an ice pack to control the pain and reduce swelling.

Your physiotherapist will teach you a series of special exercises to restore function and mobility to your knee. You should perform these at home as often as advised. After two to three weeks, you should be able to walk without crutches.

You can start incorporating gentle exercise back into your routine after two to six weeks, including swimming and long, slow walks. It's different for everyone, and your surgeon and physiotherapist will have explained to you what to do and how to know when you're ready.

You can also usually return to work at this stage, depending on the type of work you do. Most people with office jobs are able to go back into work, but if you have a manual or physical job you might need more time off. Again, your consultant will have talked you through all these factors.

You can usually drive three weeks after surgery. You won't be able to drive until you can bear weight on your leg and until you can perform an emergency stop without pain. Be sure to check your insurance policy as different providers have different rules for when you're safe to be back on the road.

Twelve weeks after surgery

At this stage, you should be well on the way to a full recovery and able to carry out everyday activities with ease. We encourage you to continue with activities such as swimming, cycling, and walking to remain fit and healthy after surgery.

You should avoid strenuous activity such as contact sport during this time. This is because you need to allow time for the grafted tissue to anchor in place inside your knee.

Full recovery from ACL surgery can take up to one year, but many people are able to get back to normal life after three months. You should be able to return to contact sport after six months. Your consultant will be able to provide you with a more specific ACL recovery timeline based on your individual circumstances.

Physiotherapy after ACL reconstruction surgery

You will meet your physiotherapist at the hospital after your operation, if not before. They will get to know you and your individual circumstances, and they'll tailor our specialised ACL reconstruction recovery programme so that it's bespoke to you. This plan will be made up of exercises to strengthen your knee muscles and improve your mobility and the range of motion in your knee. These exercises can accelerate your recovery. 

Physiotherapy is a very important part of your recovery journey at Circle Health Group. How well you follow the guidance of your physiotherapist can have a huge impact on how well and how quickly you recover.

Your physiotherapist will let you know how regularly you should do these exercises outside of your sessions, and they'll help you source any equipment you might need to help you do them. They'll also give you advice on how to incorporate exercise into your daily routine at home, so that your physiotherapy becomes a normal part of your day.

Complications as a result of ACL reconstruction surgery are uncommon, however any operation does come with potential risks. Your consultant will talk you through any potential issues and will be able to put you at ease before you have surgery. 

Risks that come with any surgery include:

  • Pain
  • Bleeding
  • Surgical wound infection
  • Unsightly scarring
  • Blood clots
  • Difficulty passing urine

Complications specific to knee surgery can include:

  • Damage to nerves around your knee
  • Infection in your knee joint
  • Discomfort in the front of your knee
  • Loss of knee movement
  • Severe pain and stiffness
  • Loss of use of your knee (complex regional pain syndrome)

Helayna Douglas is a professional football player from Glasgow. Shortly after being signed by the Celtic Under 19 Squad and embarking upon her dream career, Helayna tore her anterior cruciate ligament (ACL) during a tournament in Edinburgh. Not only was Helayna in immediate pain from the incident, but she was also extremely worried about the future of her career at that moment.

Helayna immediately researched treatment for private ACL reconstruction surgery and discovered the InternalBraceTM procedure performed by Professor Gordon MacKay at Ross Hall Hospital.

The InternalBraceTM is an innovative surgical method for ligament repair and reconstruction. The procedure (also referred to as suture tape augmentation) involves a different approach to traditional ACL reconstruction surgery by using an internal brace made of biocompatible polymer. As you recover from surgery, your ligament will grow through the structure of the brace, which acts as a scaffold when you exercise and carry out everyday movements.

"Working with Professor Mackay was a very positive experience. He was so reassuring and nice to work with. He made me feel better about my recovery as soon as I met him. I had surgery a month and a half after first contacting Ross Hall."

Helayna Douglas

Helayna is now recovered from surgery and back playing football fulltime. She would recommend the tailored procedure to anyone with a torn ACL.

Read more about Helayna's story. 

We answer your frequently asked questions about ACL reconstruction surgery.

Is ACL reconstruction surgery painful?

ACL reconstruction surgery is performed with either general anaesthetic (which means you'll be unconscious during the procedure), or a spinal anaesthetic (when anaesthetic is injected into your spine so you're conscious but unable to feel anything). While you won't feel pain during surgery, you might feel pain for the first week or two after surgery, but this can be managed effectively with painkillers.

Is ACL reconstruction surgery a keyhole surgery?

The procedure is performed using a technique called knee arthroscopy, which is also known as keyhole surgery. This is where your surgeon makes small cuts into your knee, rather than one big incision. They feed a tiny camera into your knee joint along with specially made small surgical instruments and they can see what they're doing on a video monitor.

How long does ACL reconstruction surgery take?

ACL reconstruction surgery typically takes between an hour and an hour and a half.

Can a torn ACL heal without surgery?

Without surgery, your ACL will remain torn. Pain and swelling caused by the problem can be managed and even eliminated with painkillers and physiotherapy, but it will not technically reattach or heal itself. You might be able to live a normal, active lifestyle with an effective pain management plan for a torn ACL, but you are it risk of your knee becoming increasingly damaged and painful over time. Your consultant will help you decide whether surgery is the right option for you.

How long do you stay in hospital after ACL reconstruction?

Most people can leave hospital about 24 hours after surgery. You might have to stay for longer depending on your individual circumstances. Your consultant will let you know ahead of time how long they think you will need to stay in hospital, so you can prepare for your stay.

When you choose to go private with Circle Health Group, you can expect:   

  • Flexible appointment times to fit your schedule
  • The freedom to choose your hospital and your consultant
  • Bespoke, consultant-led treatment plans tailored to your individual needs  
  • Private en-suite rooms as standard 
  • Tasty and nutritious meals cooked onsite to your dietary requirements
  • Support from the same compassionate clinical team from beginning to end  
  • Affordable, fixed-price packages with aftercare included  
  • Flexible payment options to help spread the cost of your care

If you want to know more about hip replacement surgery and find out if it's the right treatment for you, book your appointment online today or call a member of our team directly on 0141 300 5009.

ACL reconstruction surgery: explained

Consultant orthopaedic surgeon Nev Davies from Circle Reading Hospital shares what key information about what to expect from ACL reconstruction surgery, performed via keyhole surgery (a minimally invasive approach to this procedure).

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