What is involved in ACL surgery?

The steps involved in anterior cruciate ligament reconstruction surgery include:

1. Knee arthroscopy

Key-hole surgery is performed to confirm the ACL tear and identify secondary injury to the cartilage and meniscus. Any secondary injuries are treated during the same procedure.

2. Graft harvest

A donor graft is harvested, prepared, and used in order to replace the torn ACL. This can be the hamstring tendons, patellar tendon, or quadriceps tendon. The graft choice is discussed between you and Mr Pai during your consultation and depends upon your sporting and work demands. For a majority of patients, a hamstring graft is a suitable choice.

3. Tunnel drilling

Bone tunnels are created within the femur and tibia in a location that simulates ACL origin and insertion. The tunnels are required to allow passage of the graft. Getting an accurate bone tunnel is important so that favourable forces can pass through the ACL graft. An improper tunnel position can cause early re-rupture of the graft and is a common technical cause of graft failure.

4. Graft passage and fixation

The graft is passed through the bone tunnels and fixed into place with screws or over a loop of strong sutures threaded to a button.