Updated Oct. 8, 2019
ACL injury is amongst the most common sports injuries. ACL injury usually requires reconstruction surgery using soft tissue grafts. The tear will not heal on its own, and, in the majority of cases, it cannot be stitched back together.
According to Volker Musahl, MD, medical director at UPMC Rooney Sports Complex, the ligament is rebuilt using tissue grafts, usually taken from tendons in your legs. It is important to understand how the surgery is performed and what you may be facing if you undergo surgery to repair an ACL.
Understanding the procedure and risks can help you to better work with your doctor to create a recovery plan once you know what’s in-store for you.
The ACL Reconstruction Procedure
ACL reconstruction surgery is done by knee arthroscopy under general anesthesia, which means you will be asleep during the procedure. This is a minimally-invasive procedure that uses a tiny camera and surgical instruments inserted through small cuts in the knee.
The orthopaedic surgeon will remove the damaged ligament and repair any other knee damage. The surgeon will then make tunnels in the bone and bring new tissue through those tunnels and into the same place as the ACL. The new ligament is then attached to the bone with screws and/or buttons. The bone will hold the new ligament in place as it heals.
How Do Grafts Help with Repair?
Most often, the tissue grafts for the surgery come from your own body, called an autograft. They can also be taken from a donor, called an allograft. The grafts are used to create a new ligament.
The patellar tendon, which runs in front of your knee, is a common place to get tissue for the graft, but tendons in the hamstring or quadriceps are also commonly used.
An Iliotibial band (ITB) tenodesis is sometimes performed at the same time on the lateral side of your knee to provide additional stability.
Your surgeon will talk to you about what type of grafts are best for you and what tissue to use.
ACL Reconstruction Surgery Expectations and Risks
ACL reconstruction surgery works well and will give you a stable knee. How well you heal and whether you can return to high-risk sports will depend on your particular injury and how well you follow a rehabilitation program.
Dr. Musahl says you should expect about nine months of rehabilitation before you can return to regular activity.
Risks of the surgery include: bleeding, infection, and blood clot, as are common with any surgery. Other risks include:
- Loss of range of motion
- Failure of the ligament to heal
- Pain or weakness in the knee
Be sure to follow your surgeon’s instructions before and after surgery to have the best possible recovery.