ACL Reconstruction
Anterior cruciate ligament (ACL) reconstructive surgery is keyhole (arthroscopic) surgery using a narrow pencil sized fibre-optic camera and light to look inside the knee joint. The torn ACL is removed and replaced with a tendon graft, most commonly taken from the hamstring tendons at the back of your leg, usually from the same leg.
During the procedure:
the ruptured ACL is removed
small tunnels are drilled into the bone
the tendon graft is passed through these tunnels
the graft is secured using a steel button and screw.
Following surgery, it is essential to allow at least six months for the graft to heal and mature before returning to heavy physical activity. Most patients return to higher‑level sport or demanding activities at 9-12 months after surgery.
Immediately after surgery
Most patients stay in hospital for one night. You will receive pain relief, intravenously (through a drip) and/or in tablet form. Two small drains in your knee during surgery and removed you go home.
A physiotherapist will see you prior to discharge to outline your rehabilitation.
Mobility and walking aids
You should rest for the first few days after surgery and use two crutches for one to two weeks, then one crutch held in the hand opposite to your operated knee for another week or two. Gradually increase the weight through your knee.
You must be collected on discharge, as you cannot drive.
Caring for your wounds
A compression bandage is applied after surgery to reduce swelling and can be removed two days after the procedure.
Underneath, you will have small waterproof dressings over the incisions. These must remain clean, dry, and intact for two weeks.
Your stitches are dissolving and do not need removal.
A small amount of blood staining is normal. If you are concerned about excessive bleeding:
apply gentle pressure
rest and elevate the leg
apply ice.
If bleeding continues, please contact our rooms.
Do not have a bath or and swim until four weeks after your operation.
Managing your pain after surgery
Some swelling and pain are a normal part of recovery and will gradually improve.
These are best managed by:
resting and elevating your leg when seated
applying ice for 20–30 minutes every few hours
taking pain relief as prescribed
resting for the first few days.
You will be discharged with pain medication. For ongoing pain management, please arrange a review with your GP.
Most patients taper off pain relief by three to four weeks after surgery.
If you are worried about your level of pain, please contact our rooms for reassurance and to rule out rare complications.
Recovery timeline
Protecting your ACL graft is essential, as it takes at least six months to mature and heal. Mr Patten will advise you specifically about returning to more rigorous activities.
Returning to work
Desk‑based work: 1–2 weeks
Manual or labour‑intensive work: If your work is more labour-intensive or you need to frequently use stairs or climb ladders, you will require a longer period off work and Mr Patten will advise you directly.
Driving
Right knee surgery: approximately 3 weeks
Left knee surgery: 1–2 weeks for automatic car and approximately 3 weeks for manual car)
Risks and complications
ACL reconstructive surgery is very safe and although uncommon, complications can sometimes occur including a very low risk of infection which may require antibiotics, excessive swelling or bleeding inside the joint which generally requires rest and a firm bandage.