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Arthroscopic ACL Reconstruction

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Arthroscopic ACL Reconstruction is a minimally invasive orthopaedic surgery performed to replace a torn anterior cruciate ligament (ACL) in the knee. The surgery is done using arthroscopy, where a small camera (arthroscope) and specialized instruments are inserted through small incisions.

The ACL is one of the main ligaments that stabilizes the knee joint, especially during pivoting, cutting, or sudden direction changes.

Causes of ACL Injury

ACL injuries commonly occur due to:

    • Sports injuries (football, basketball, cricket, skiing)
    • Sudden twisting or pivoting movements
    • Landing incorrectly after a jump
    • Direct impact to the knee
    • Road traffic accidents
Symptoms of ACL Tear
  • Sudden “pop” sound in the knee
  • Severe knee pain
  • Rapid swelling
  • Knee instability or giving way
  • Difficulty walking or bearing weight
Graft Options Used in ACL Reconstruction
  1. Hamstring Tendon Graft
    • Taken from semitendinosus ± gracilis tendon.
    • Commonly used with good outcomes.
  2. Patellar Tendon (Bone–Patellar Tendon–Bone) Graft
    • Central portion of patellar tendon with bone blocks.
  3. Quadriceps Tendon Graft
    • Tendon taken from the quadriceps above the patella.
  4. Allograft
    • Tendon obtained from a donor tissue bank.
Basic Surgical Steps
  1. Arthroscope inserted through small portals around the knee.
  2. Torn ACL remnants are removed and the joint is inspected.
  3. Bone tunnels are drilled in the femur and tibia.
  4. Tendon graft is passed through the tunnels to replicate the ACL.
  5. Graft fixation with screws or fixation devices.
  6. Stability and movement of the knee are checked.
Advantages of Arthroscopic Technique
  • Small incisions
  • Less pain and tissue damage
  • Better visualization of the joint
  • Shorter hospital stay
  • Faster recovery
Recovery and Rehabilitation
  • Walking with support: usually within 1–2 days
  • Physiotherapy: essential for regaining strength and motion
  • Return to daily activities: about 6–8 weeks
  • Return to sports: usually 6–9 months
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Possible Complications
  • Infection
  • Knee stiffness
  • Graft failure or re-tear
  • Blood clots
  • Persistent instability

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    Arthroscopic ACL reconstruction is considered the gold standard treatment for symptomatic ACL tears, particularly in young and active individuals, helping restore knee stability and return to sports activities.