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ACL reconstruction - Overview

Alternative Names

Anterior cruciate ligament repair; Knee surgery

Definition of ACL reconstruction:

ACL reconstruction is surgery to replace the ligament in the center of your knee with a new ligament. The anterior cruciate ligament (ACL) keeps your shin bone (tibia) in place. A tear of this ligament can cause your knee to give way during physical activity.

Description:

You will probably receive general anesthesia right before surgery. This means you will be unconscious and unable to feel pain. Sometimes, other kinds of anesthesia are used for this surgery.

The tissue that will replace your damaged ACL will come from your own body or from a donor. A donor is a person who has died and, before death, chose to give all or part of their body to help others.

  • Tissue taken from your own body is called an autograft. The two most common places to take tissue from are a tendon in your knee or your hamstring. Your hamstring is a tendon behind your knee.
  • Tissue taken from a donor is called an allograft.

The procedure is usually done by knee arthroscopy. With arthroscopy, a tiny camera is inserted into the knee through a small incision (cut). The camera is connected to a video monitor in the operating room. Your surgeon will use the camera to check the ligaments and other tissues of your knee.

Your surgeon will make other small cuts around your knee and insert other medical. Your surgeon will repair any other damage found. Your surgeon then will replace your ACL by following these steps:

  • The old ligament will be removed with a shaver or other instruments.
  • If your own tissue is being used to make your new ACL, your surgeon will make a larger cut. Then, your surgeon will remove this tissue through the larger cut.
  • Your surgeon will make tunnels in your bone to bring the new tissue through. This new tissue will be in the same place as your old ACL.
  • Your surgeon will attach the new ligament to the bone with screws or other devices to hold it in place. As it heals, the bone tunnels fill in. This secures the new ligament more.

At the end of the surgery, your surgeon will close your incisions with sutures (stitches) and put a dressing on them. Most surgeons take pictures during the procedure from the video monitor so that afterward you can see what was found and what was done.

  • Reviewed last on: 2/3/2009
  • C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Phillips BB. Arthroscopy of the lower extremity. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 48.

Streich NA. Reconstruction of the ACL with a semitendinosus tendon graft: a prospective randomized single blinded comparison of double-bundle versus single-bundle technique in male athletes. Knee Surg Sports Traumatol Arthrosc. March 1, 2008;16(3): 232-8.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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