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Arthroscopic ACL Reconstruction

Medically reviewed by Last updated on Aug 31, 2022.

What do I 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.

How do I prepare for surgery?

  • Your surgeon will tell you how to prepare for surgery. He or she may tell you not to eat or drink anything after midnight before your surgery. Arrange to have someone drive you home after surgery.
  • Tell your surgeon about all your current medicines. He or she will tell you if you need to stop any medicine for surgery, and when to stop. He or she will tell you which medicines to take or not take on the day of surgery.
  • Tell your surgeon if you have any allergies, including to anesthesia or medicines.

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.
  • Your surgeon will use an arthroscope to look inside your knee joint by inserting it through the incision. More 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 in place.
  • The incisions will be closed with stitches, staples, or medical tape. A drain may be placed temporarily to remove fluid from the surgery area.

What should I expect 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 (PT) is used to help you improve movement and strength, and to decrease pain. You may begin PT while you are in the hospital and continue for several weeks after you get home.

What are the 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.

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