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For those with a damaged anterior cruciate ligament (ACL), surgery may be recommended as a treatment option. During this surgery, the damaged ACL is removed and replaced with a graft. Once an incision is made in your knee, the doctor will remove the torn ends of the anterior cruciate ligament and replace them with a patellar tendon, hamstring tendon, or an allograft. When the surgery is complete, a hinged knee brace may be placed to keep your knee in a straight position while it heals.

What Is ACL Surgery?

ACL surgery is a procedure that removes a damaged anterior cruciate ligament (ACL) and replaces it with an ACL graft. There are at least three choices that your doctor can use for a graft, each with its advantages and disadvantages. These include:
  • The hamstring tendon
  • The patellar tendon
  • An allograft (a tendon that comes from a cadaver).

Beginning Surgery on Your ACL

After the anesthesia is given, a tourniquet or blood pressure cuff is usually wrapped around your thigh to temporarily stop the flow of blood to your knee. This allows your doctor to see the surgical area more clearly.
To help reduce the chance of infection, the area will be scrubbed with a special soap, and you will be covered with sterile sheets. The only area exposed will be the site where the procedure is being performed.
Your doctor will begin the surgery by making three small incisions about a quarter-inch in length. One is located above the kneecap and the other two are below it. Your knee is then filled with fluid to expand the joint so that your doctor can see better inside. Through one of the incisions, the arthroscope is then inserted. Once the arthroscope is in the correct position, your doctor will begin to examine the structures of your knee on a video monitor, looking for any damage to the menisci or articular cartilage. If an injury is seen, your doctor will treat it at that time. When the cartilage work is done, your doctor will then proceed with the ACL reconstruction.
Written by/reviewed by:
Last reviewed by: Arthur Schoenstadt, MD
Last updated/reviewed:
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