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Arthroscopic ACL Reconstruction


What you need to know about arthroscopic anterior cruciate ligament (ACL) reconstruction:

ACL reconstruction is surgery to replace your torn ACL. The ACL is a ligament in your knee that connects the tibia (shin bone) to the femur (thigh bone). Ligaments are strong tissues that connect bones. Surgery is done through small holes in the skin. A tool called an arthroscope is used to help your surgeon see the area to be fixed.

How to prepare for surgery:

Your healthcare provider will talk to you about how to prepare for surgery. He may tell you not to eat or drink anything after midnight on the day of your surgery. He will tell you what medicines to take or not take on the day of your surgery. Arrange for someone to drive you home after your surgery.

What will happen during surgery:

  • You may get regional anesthesia that will make you lose feeling in your leg. You may get general anesthesia to keep you asleep and free from pain during surgery. A small incision will be made in your knee. Healthcare providers will use an arthroscope to look inside your knee joint by inserting it through the incision. Additional small incisions will be made in several places around your knee. Tools will be put into these incisions to reconstruct your injured ACL.
  • Another incision will be made if the graft (piece of tendon or muscle) will be taken from another part of your body. The graft will be pulled through a tunnel drilled in your tibia and femur. Screws will be used to hold it. The incisions will be closed with stitches, staples, or medical tape. A drain may be placed temporarily to remove fluid from your wound.

What will happen after surgery:

You will be taken to a room to rest until you are fully awake. Healthcare providers will watch you closely for any problems. Do not get out of bed until your healthcare provider says it is okay. You will then be taken to your room or allowed to go home.

  • You may need to walk around the same day of surgery , or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Talk to healthcare providers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to ask for help.
  • An electrical muscle stimulator (EMS) may be used to decrease your pain after surgery. Sticky pads are put on the skin around your knee. Electrical impulses go into one pad and energy comes out the other. This treatment may last 15 to 20 minutes one or more times a day. EMS makes your muscles contract. This helps your muscles heal and get stronger.
  • Medicines may be given to prevent or fight a bacterial infection. You may also get medicine to prevent nausea or to reduce pain, swelling, or fever.
  • Physical therapy is used to help you improve movement and strength, and to decrease pain.

Risks of ACL reconstruction:

You may develop an infection or bleed more than expected. You could have trouble breathing or develop blood clots. Even after surgery, the knee may not go back to the way it was before.


  • Pain medicine: You may need medicine to take away or decrease pain.
    • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.
    • Do not wait until the pain is severe before you take your medicine. Tell your healthcare provider if your pain does not decrease.
    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.


  • Elevate your knee. Keep your knee raised above the level of your heart as often as you can. This will help decrease or limit swelling. Elevate your knee by resting it on pillows.
  • Apply ice. Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel and place it on your wound for 15 to 20 minutes every hour. Use the ice for as long as directed.
  • Rest your knee. The joint needs to be rested so it can heal. Return to normal activities as directed.
  • Apply compression. Ask your healthcare provider if you should wrap an elastic bandage around your injured ligament. Compression provides support and helps decrease swelling and movement so your joint can heal. Do not wrap the bandage tightly. It should be snug, but you should be able to slip a finger between the bandage and your skin.
  • Physical therapy is used to help you improve movement and strength, and to decrease pain.
  • A continuous passive motion (CPM) machine is a device that slowly and gently moves your joint while you are in bed. The machine can increase your range of motion, strengthen your muscles, and decrease pain. Your healthcare provider may tell you use a CPM machine with other treatments, such as physical therapy.

Use support devices as directed:

  • A knee brace may be used to limit your movement and protect your knee. Your healthcare provider will tell you when you can unlock the brace. Keep it locked at all other times. Ask your healthcare provider for more information about your knee brace.
  • Crutches may help decrease your pain as you move around. Crutches help decrease strain on your knee. Use crutches as directed.

Wound care:

  • Keep your bandage and stitches clean and dry. Do not remove the bandage over your wound or get it wet unless your healthcare provider says it is okay. Ask when you can bathe. Do not trim or shorten the ends of your stitches. If the stitches rub against your clothing, you can put a soft gauze bandage between the stitches and your clothes. Strips of medical tape that were placed over your incision will start to peel off on their own. If they have not fallen off within 14 days, you can carefully peel them off.
  • Wash your hands. Always wash your hands before and after you care for your wound to prevent infection.
  • Change your bandage and clean your wound as directed. Ask for help if you cannot reach your wound.

Follow up with your healthcare provider as directed:

You may need to return to have your stitches removed. Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Arthroscopic ACL Reconstruction (Ambulatory Care)

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