What is the ACL?
The Anterior Cruciate Ligament (ACL) is one of the most important ligaments in the knee. It connects the thighbone (femur) to the c (tibia) and plays a major role in stabilizing your knee during activities like running, jumping, and changing direction quickly.
When the ACL tears — often due to sports or high-impact activity — it can cause the knee to become unstable, painful, and swollen. This injury makes it difficult or impossible to continue physical activity without medical intervention.
How Do ACL Injuries Happen?
ACL injuries are common in sports such as:
- Soccer
- Football
- Basketball
- Gymnastics
Most ACL tears happen when a person suddenly changes direction, lands awkwardly from a jump, or collides with another player. These movements put stress on the ligament, and if the force is too great, it can tear completely.
Signs and Symptoms of a Torn ACL
If you’ve torn your ACL, you may experience:
- A loud “pop” at the time of injury
- Immediate swelling and pain
- Instability or “giving way” of the knee
- Difficulty standing or walking
- Loss of full range of motion
An orthopedic doctor typically confirms an ACL tear with physical tests and imaging, such as an MRI.
What is ACL Reconstruction Surgery?
ACL reconstruction is a procedure that replaces the torn ligament with a new one. This new ligament is often made using:
- An autograft (from your own body — usually hamstring or patellar tendon)
- An allograft (from a donor cadaver)
The surgery is usually minimally invasive and performed using arthroscopy — a technique involving small incisions and a camera. The new graft is secured into place with screws or other fixation devices to allow the body to heal and incorporate the tissue over time.
Do You Need ACL Reconstruction?
Not every ACL tear requires surgery. However, ACL reconstruction is often recommended if you:
- Are an athlete or physically active
- Experience knee instability during daily activities
- Want to prevent further knee damage, such as cartilage or meniscus tears
- Are under the age of 40 and lead an active lifestyle
Older adults or individuals with a sedentary lifestyle may manage with non-surgical treatments, including physical therapy and bracing.
What Happens Before Surgery?
Before your ACL reconstruction, your doctor may suggest a few weeks of “prehab” — physical therapy aimed at:
- Reducing swelling
- Improving range of motion
- Strengthening muscles around the knee
This improves your post-op recovery and surgical outcome. You’ll also meet with your surgical team to discuss:
- The type of graft
- Anesthesia options
- Risks and benefits of surgery
What to Expect During ACL Surgery
ACL reconstruction is typically done as an outpatient procedure, which means you go home the same day. The surgery usually lasts 1 to 2 hours. Here’s a basic overview:
- You receive anesthesia (either general or regional)
- Small incisions are made in the knee for the arthroscope and surgical tools.
- The torn ACL is removed.
- The new graft is inserted and secured.
- The incisions are closed, and a bandage or brace is applied.
Recovery Timeline After ACL Reconstruction
Recovery from ACL surgery is a gradual process, often lasting 6 to 9 months. Your doctor and physical therapist will guide you through various recovery stages:
Weeks 1–2: Rest and Protection
- Use crutches and a knee brace
- Focus on reducing swelling and pain
- Begin gentle range of motion exercises
Weeks 3–6: Regaining Motion
- Transition off crutches
- Begin light strengthening exercises
- Improve knee flexion and extension
Months 2–4: Strengthening
- Increase resistance in exercises
- Start low-impact activities like stationary biking
- Improve balance and coordination
Months 4–6: Functional Training
- Resume moderate activities
- Begin light jogging (if cleared by your therapist)
- Sport-specific drills for athletes
Months 6–9: Return to Sport
- Final strength and agility training
- Functional movement assessments
- Clearance from your surgeon to return to full activity
Risks and Potential Complications
ACL reconstruction is a safe and effective procedure, but like any surgery, it carries some risks. These may include:
- Infection
- Bleeding
- Knee stiffness
- Blood clots
- Graft failure or re-tear
- Ongoing knee pain or instability
Choosing an experienced surgeon and following your rehab plan carefully will help reduce these risks.
