ACL reconstruction, or anterior cruciate ligament surgery, is a surgical procedure used to restore normal knee stability after an ACL injury. ACL reconstruction can be performed as an outpatient procedure with minimal incision and low complication rates.

Advanced arthroscopic techniques provide surgeons with direct visual access to knee structures, making it easier to perform ligament reconstruction. A minimally invasive procedure can be performed at the same time as arthroscopy, increasing the chances of a successful return to sports or daily activity.

The ACL is a strong rope-like structure located in the center of the knee, running from the femur to the tibia. It is a stabilizing ligament that is responsible for keeping the shinbone in line with the thighbone so your knee can remain stable and straight. When this ligament tears, unfortunately, it does not heal on its own, and often leads to instability in the knee.

An ACL injury can occur in sports that involve sudden directional changes, such as soccer and football, or slowing down while running, such as basketball and tennis. The ACL is torn when your knee twists or bends the wrong way. Contact during a direct blow to the side of your knee, such as in a football tackle, can also damage your ACL.

In an ACL injury you may hear a loud snapping or popping sound, or instead hear grinding or crunching when the knee is rotated or moved. Within an hour after an ACL injury, you are likely to notice swelling in the area of the ligament tear, pain when using the knee, and loss of stability in the knee joint.

If an ACL injury is suspected in a patient, X-rays and MRI scans can be done to rule out any other injuries. A Lachman’s test can be done to test the integrity of the ACL. As part of this test, when the knee is bent to a 30° angle, the stability of the knee should remain intact when the tibia moves into place in relation to the femur. The pivot shift test can also be performed to assess ACL integrity. During this test, if the patient has an ACL tear, the tibia will continue moving forward as the knee bends past 30° and it will not shift back into position until after it has straightened up again.

Recent research focuses on the repair of torn ACLs (such as with an avulsion, or separation, at the end attachment to the femur) with various techniques. The torn ACL is typically replaced by a substitute graft made of tendon (including semitendinosus, gracilis and posterior tibialis). Currently, there is not sufficient evidence to support widespread use of biologics to promote healing.

If you have a soccer, tennis, basketball and football or ski injury, if you need to plan your daily activities or if you are an athlete suffering after an injury, we can help you.

If you have ACL injury, surgical reconstruction is an option. Our surgeon will tell you if you are a candidate for the surgery. Weight bearing and range of motion activities should be delayed for 4-6 weeks to allow time for neovascularization (new blood vessel formation). To avoid stiffness after surgery and ensure the best results, we will design a custom rehabilitation for your ACL.

As with any type of surgery, there are risks associated with ACL surgery. Some of these risks include:

• Infection
• Shock
• Blood clots
• Breathing issues
• Trouble peeing
• Knee pain
• Stiffness in your knee
• A graft not healing well
• A graft failing after you return to physical activity

ACL reconstruction is the gold standard for treating knee injuries of the anterior cruciate ligament. ACL reconstruction is the only proven, effective method of restoring a knee joint’s stability and function after an ACL tear.