ACL reconstruction is surgery to replace the ligament in the center of your knee with a new ligament. The anterior cruciate ligament (ACL) keeps your shin bone (tibia) in place. A tear of this ligament can cause your knee to give way during physical activity.

You will probably receive general anesthesia right before surgery. This means you will be unconscious and unable to feel pain. Sometimes, other kinds of anesthesia are used for this surgery.

The tissue that will replace your damaged ACL will come from your own body or from a donor. A donor is a person who has died and, before death, chose to give all or part of their body to help others.

• Tissue taken from your own body is called an autograft. The two most common places to take tissue from are a tendon in your knee or your hamstring. Your hamstring is a tendon behind your knee.
• Tissue taken from a donor is called an allograft.

The procedure is usually done by knee arthroscopy. With arthroscopy, a tiny camera is inserted into the knee through a small incision (cut). The camera is connected to a video monitor in the operating room. Your surgeon will use the camera to check the ligaments and other tissues of your knee.

Your surgeon will make other small cuts around your knee and insert other medical. Your surgeon will repair any other damage found. Your surgeon then will replace your ACL by following these steps:

• The old ligament will be removed with a shaver or other instruments.
• If your own tissue is being used to make your new ACL, your surgeon will make a larger cut. Then, your surgeon will remove this tissue through the larger cut.
• Your surgeon will make tunnels in your bone to bring the new tissue through. This new tissue will be in the same place as your old ACL.
• Your surgeon will attach the new ligament to the bone with screws or other devices to hold it in place. As it heals, the bone tunnels fill in. This secures the new ligament more.

At the end of the surgery, your surgeon will close your incisions with sutures (stitches) and put a dressing on them. Most surgeons take pictures during the procedure from the video monitor so that afterward you can see what was found and what was done.

We know that NOT treating a torn ACL can lead to tissue damage and early arthritis. ACL reconstruction may be recommended for these knee problems:

• Knee that gives way or feels unstable during daily activities
• Knee pain
• Inability to continue playing sports or other activities, especially ones with cutting or pivoting.
• Other ligaments are also injured.

Before choosing to have this surgery, you should understand the time and effort rehabilitation (recovery) will take. You will need to stick to a program for 4 to 6 months before you can return to full activity. The success of the surgery depends on your sticking with your rehabilitation program.