Most surgery for anterior cruciate ligament (ACL) injuries involves replacing the ACL with tissue called a graft. Usually an autograft (tendon tissue taken from another part of the body) is used. Repair is also done when the ACL has been torn from the upper or lower leg bone (avulsion). The bone fragment connected to the ACL is reattached to the bone.
Most ACL surgery is done by making small incisions in the knee and inserting surgical tools through these incisions (arthroscopic surgery). Open surgery (cutting a large incision in the knee) is sometimes required.
Goals of surgery
The goals of surgical treatment for ACL injuries are to:
- Restore normal or almost normal stability in the knee.
- Restore the level of function you had before the knee injury.
- Limit loss of function in the knee.
- Prevent injury or degeneration to other knee structures.
Most people who have ACL surgery have favorable results, with reduced pain, good knee function and stability, and a return to normal levels of activity. But some still have knee pain and instability. Athletes and those who take part in sports typically can return to their sports within months. But this may depend on how intense and sports-focused the rehab was.
- ACL Injury: Should I Have Knee Surgery?
Exercises before surgery
Before ACL surgery, strength and motion exercises are often done to help get the knee ready for surgery and for rehab after surgery. Surgery is followed by a short period of home exercises, increased activity, and the use of crutches for walking.
An intensive rehab program to strengthen the knee then begins. The rehab program often lasts up to a year.
ACL Injury: Exercises to Do Before Treatment
Surgery in children and teens
Surgery for ACL injuries in children and teens involves special concerns, because children's bones are still growing. Talk to your doctor about the benefits and risks of surgery.
What to think about
Depending on how bad your injury is, surgery with rehab may offer the best chance of making your knee stable again. It also may help you return to an active lifestyle without further pain, injury, or loss of strength and movement in your knee.
If your injured knee gives out now and then (chronic ACL deficiency) and you continue to do activities that require a stable knee, you may injure your knee again. That may be another reason to consider surgery.
You will need to follow a rehab program whether or not you have surgery. If you don't complete a rehab program, even with surgery you may not regain full stability and function in your knee.