Mr Matthew Gee MBBS, BSC, MSC, FRCS (Tr&Orth) Consultant Orthopaedic Surgeon

ACL Reconstruction

Surgical ACL reconstruction can help to restore stability to a damaged ligament in the knee. The ACL can be repaired with a graft during a knee arthroscopy procedure.

Who Should Consider Knee Arthroscopy and ACL Reconstruction?

The anterior cruciate ligament (ACL) is a fibrous band of tissue that helps to keep the knee stable. If the ACL is torn or sprained, it can cause pain, instability and reduced mobility. Surgery isn’t always necessary for an ACL injury, but it could be a good idea if the knee remains unstable and you are in pain or unable to perform your usual activities or sport. Your orthopaedic surgeon may also recommend ACL reconstruction if there is other damage to the joint that can be repaired during the knee arthroscopy. However, it may be better to try other options such as physiotherapy first.

The Procedure

Knee arthroscopy is a keyhole procedure that can be performed under a general anaesthetic or with an epidural. The surgeon will make several small incisions on your knee, through which the arthroscope and surgical instruments will be passed. The arthroscope is a flexible camera that enables the surgeon to see inside the knee. The first stage of the procedure is to prepare the graft, which is usually taken from a nearby tendon. In some cases a donor graft will be used instead. The graft will be attached to the femur and shin bone as close as possible to the damaged ACL. It will usually be fixed with screws or staples. After checking that the graft has the correct tension and movement, the surgeon will close the incisions. You should be able to go home the same or next day, but it can take up to six months for you to recover fully. The graft will act as a scaffold to encourage the ligament to regenerate, which should help to restore your mobility.

Risks and Benefits

If you are considering ACL reconstruction, it is important to be aware of both the risks and benefits of the knee arthroscopy surgery:

  • Although serious complications are rare, there is a small chance of problems such as infection or an allergic reaction to the anaesthetic. Since the repair is a keyhole procedure, the risks are lower than for open surgery.
  • The graft can sometimes fail, which could leave you with stiffness, instability or knee pain. In some cases the surgery may not be able to restore the same level of mobility as before the injury.
  • In most cases, the surgery will help to stabilise your knee and relieve any pain. Repairing the ACL can also reduce the risk of further injuries and enable you to return to your usual activities including playing sports.

If you are suffering from an ACL injury and you would like to discuss the options for treatment, get in touch to arrange a consultation with an experienced orthopaedic surgeon.


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