Anterior cruciate ligament (ACL) reconstruction

ACL reconstruction is keyhole surgery to replace a torn anterior cruciate ligament with a graft. The aim is to restore stability and help you return to everyday movement and, where appropriate, sport with confidence.

Anterior cruciate ligament (ACL) reconstruction overview

The anterior cruciate ligament is one of the main ligaments that keeps your knee stable. During ACL reconstruction, the damaged ligament is replaced with a graft, usually taken from a tendon elsewhere in your body. Donated tissue may be considered in some circumstances. Not every ACL injury needs surgery. Your consultant will talk through your symptoms, activity goals and response to physiotherapy before helping you decide whether reconstruction is right for you.

How is surgery carried out?

ACL reconstruction is usually carried out using arthroscopy, a type of keyhole surgery. A small camera allows the surgeon to examine the knee, check for other damage and guide the procedure.

The torn ligament is removed and the graft is positioned where the ACL was. It is secured to the thigh bone and shin bone using screws or other fixation devices. The surgeon then checks the movement and stability of the knee before closing the small incisions.

Are there any risks?

Most people do not experience a serious complication, but every operation carries risks. Your consultant will explain how these apply to you. Possible complications include:

  • infection
  • a blood clot in the leg, known as deep vein thrombosis (DVT)
  • damage to a nerve, blood vessel or other tissue
  • ongoing pain, swelling or stiffness
  • continued instability or restricted movement
  • pain or weakness where the graft was taken
  • the graft stretching or tearing, which may require further surgery

 

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Anterior cruciate ligament (ACL) reconstruction overview

Recovery from ACL reconstruction

6-8 weeks

Early recovery: restoring movement

During the first six to eight weeks, the usual goals are to reduce pain and swelling, fully straighten the knee, improve bending and walk without a limp. You will also begin rebuilding strength and balance under the guidance of your physiotherapist.

3-4 months

Building strength and returning to running

At around three to four months, some people may be ready to begin a carefully controlled return to jogging. This should only start when your knee is settled and you have regained enough strength, control and confidence.

6-9 months

Returning to sport

Returning to sport is based on your progress rather than time alone. Your care team will assess your strength, agility, coordination, landing control and confidence before advising that it is safe. For some sports, this can take nine to twelve months or longer.

How to pay

We offer flexible options depending on how you choose to access care at Fortius. Whichever option you choose, we’ll help make the process clear and straightforward from the start.

Private medical insurance

Private medical insurance

If your care is covered by private medical insurance, we’ll usually invoice your insurer directly. Please check your policy in advance and request an authorisation code if your insurer requires one. You’ll be responsible for paying any policy excess or costs that aren’t covered by your insurance.

Paying for yourself

Paying for yourself

You don’t need private medical insurance to access care at Fortius. If you’re paying for your own treatment, our team will explain the costs clearly and provide a personalised quote before you decide whether to go ahead.

 

Anterior cruciate ligament (ACL) reconstruction FAQs

Do not drive until you can control the vehicle safely, including performing an emergency stop, and you are no longer affected by pain or medication. Ask your surgeon for advice and check that your motor insurer is satisfied you are covered.

This depends on your recovery and the demands of your role. People with desk-based jobs may be able to return sooner than those whose work involves lifting, kneeling or prolonged standing. Your consultant or physiotherapist will give you personalised guidance.

Your return will be planned around your sport, strength and movement tests, and confidence in the knee. It can take up to a year to return to pivoting or contact sport. Follow your rehabilitation plan and do not progress before your physiotherapist advises you to.

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