What actually happens during ACL reconstruction surgery?

Before the operation starts

You meet the anaesthetist, who usually offers a general anaesthetic or a spinal anaesthetic, often combined with a nerve block to reduce pain afterwards. The correct knee is marked, and antibiotics are given into a vein to lower infection risk. You will not feel the surgery.

The main steps

• Examination under anaesthesia to confirm the degree of looseness
• A camera (arthroscope) is inserted through small cuts at the front of the knee
• The whole joint is checked; meniscus tears are repaired or trimmed and cartilage is assessed
• The graft is taken, for example from the hamstring, patellar tendon or quadriceps tendon, and prepared to size
• Tunnels are drilled at the natural attachment points of the original ACL
• The graft is passed through and fixed with devices such as buttons or screws, under the right tension
• The knee is moved through its range to check stability before the cuts are closed

Extra procedures sometimes needed

Depending on the knee, the operation may include meniscus repair, treatment of a cartilage defect, or a lateral extra-articular procedure that adds rotational control in selected high-risk patients. These are discussed beforehand, as they can change rehabilitation and recovery time.

Waking up and going home

You wake up with a dressing, sometimes a brace and an ice device. Physiotherapists usually help you stand and walk with crutches the same day. Many patients go home the same day or after one night, depending on pain control and the procedures done. Dr. Gelber explains what was found and done before you leave Aman Hospital.