ACL Reconstruction Surgery: A Step-by-Step Guide

If you’ve recently torn your anterior cruciate ligament (ACL), you’re probably considering surgery. While there are non-surgical options available, many athletes and active individuals opt for surgery to repair the ligament and regain full function of their knee. Here’s what you can expect during an ACL reconstruction surgery.

What is ACL Reconstruction Surgery?

An ACL reconstruction surgery is a procedure that aims to repair a torn anterior cruciate ligament in the knee. The ACL is one of the major ligaments in the knee and is responsible for providing stability to the joint. When it’s torn, the knee becomes unstable and can give out during physical activity.

The surgery of acl tear treatment involves removing the damaged ligament and replacing it with a graft, which is usually taken from the patient’s own body or from a donor. The graft is secured in place with screws or other devices and eventually integrates with the surrounding tissue to provide stability to the knee.

Step-by-Step Guide to ACL Reconstruction Surgery

Pre-Operative Preparation

Before your surgery, you’ll have a pre-operative consultation with your surgeon. During this appointment, your surgeon will review your medical history, perform a physical exam, and order any necessary imaging tests such as X-rays or an MRI.

Your surgeon will also discuss the surgical procedure with you, including the potential risks and benefits, and what to expect during your recovery. It’s important to ask any questions you have and make sure you fully understand the procedure before you agree to undergo surgery.


ACL reconstruction surgery is typically performed under general anesthesia, which means you’ll be unconscious during the procedure. In some cases, regional anesthesia may be used to numb the area around the knee.


Once you’re under anesthesia, your surgeon will make a small incision in the knee to access the damaged ACL. The size and location of the incision will depend on the surgical technique used and the preference of your surgeon.

Removing the Damaged Ligament

Next, your surgeon will carefully remove the damaged ACL from the knee. This is done using specialized instruments to cut and remove the ligament from the surrounding tissue.

Preparing the Graft

Once the damaged ligament has been removed, your surgeon will prepare the graft that will be used to replace it. This may involve taking a small piece of tissue from another part of your body, such as the patellar tendon or hamstring, or using a graft from a donor.

Securing the Graft

After the graft has been prepared, your surgeon will position it in the knee and secure it in place using screws or other devices. The graft will eventually integrate with the surrounding tissue, creating a new ligament to stabilize the knee.

Closing the Incision

Once the graft has been secured in place, your surgeon will close the incision using stitches or staples. A dressing or bandage will be applied to the knee to protect it during the initial stages of healing.


After the surgery, you’ll be monitored closely in the recovery room until the effects of the anesthesia wear off. You may experience some pain and swelling in the knee, and you’ll be given pain medication and instructions on how to care for your knee during the initial stages of healing.

Physical therapy is an important part of the recovery process after ACL reconstruction surgery. Your surgeon will likely recommend a physical therapist who will help you regain strength and mobility in your knee through a series of exercises and stretches.

You may also need to use crutches or a brace to support your knee during the early stages of recovery. It’s important to follow your surgeon’s instructions carefully and attend all scheduled follow-up appointments to ensure a successful recovery.

Risks and Complications

As with any surgical procedure, there are potential risks and complications associated with ACL reconstruction surgery. These can include:

  • Infection at the surgical site
  • Bleeding
  • Nerve damage
  • Blood clots
  • Failure of the graft to integrate with the surrounding tissue
  • Re-tearing of the ACL
  • Limited range of motion in the knee

While these risks are relatively rare, it’s important to discuss them with your surgeon and take steps to minimize your risk. This may include following pre-operative instructions carefully, such as stopping certain medications or not eating or drinking before the surgery.

It’s also important to follow all post-operative instructions carefully to reduce the risk of complications. This may include taking prescribed medications, attending physical therapy appointments, and avoiding certain activities until your knee has fully healed.

Preparing for Surgery

In addition to discussing the potential risks and benefits of the procedure with your surgeon, there are some steps you can take to prepare for ACL reconstruction surgery. These include:

  • Quitting smoking: Smoking can impair the healing process and increase the risk of complications after surgery. If you smoke, it’s important to quit at least several weeks before your surgery.
  • Eating a healthy diet: Eating a balanced diet with plenty of fruits, vegetables, and lean protein can help support the healing process and reduce the risk of complications.
  • Staying active: Maintaining a regular exercise routine can help improve your overall health and fitness before surgery. However, it’s important to talk to your surgeon about which activities are safe and which should be avoided before your surgery.
  • Planning for recovery: Before your surgery, it’s important to make arrangements for your recovery period. This may include arranging for someone to help with household tasks or childcare, taking time off work, or making adjustments to your living space to accommodate mobility aids such as crutches or a wheelchair.

Alternative Treatments

While ACL reconstruction surgery is a common and effective treatment for a torn ACL, it’s not the only option available. Some alternative treatments for a torn ACL may include:

  • Non-surgical management: For some patients, non-surgical treatments such as physical therapy, rest, and bracing may be effective in reducing pain and improving knee function.
  • Prolotherapy: This is a type of injection therapy that involves injecting a solution into the knee to promote healing of the damaged ligament.
  • Platelet-rich plasma (PRP) therapy: This involves injecting a concentrated solution of the patient’s own blood platelets into the knee to promote healing.
  • Stem cell therapy: This involves injecting stem cells into the knee to promote healing of the damaged ligament.

Final Thoughts

ACL reconstruction surgery is a common procedure used to repair a torn anterior cruciate ligament in the knee. While the surgery can be complex, understanding the step-by-step process can help you feel more prepared and informed about what to expect.

If you’re considering ACL reconstruction surgery, it’s important to talk to your doctor about the potential risks and benefits, as well as the recovery process. With the right care and support, many patients are able to return to their normal activities and enjoy a full recovery after ACL reconstruction surgery.