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Anterior Cruciate Ligament (ACL) Surgery

General Information

The anterior cruciate ligament (ACL) is one of four ligaments in the knee joint. The ligament connects the distal or lower head of the femur, or long bone of the thigh to the upper end of the tibia or shinbone at the knee. The ligament is extremely important in knee joint stability and can be damaged through fast changes in direction as well as pivoting or twisting movements, as is common in many sports. The ACL surgery procedure replaces the damaged ligament with a graft of your hamstring or kneecap tendon that is inserted in its place.

Reasons for Repair

  • Reduction of pain
  • Increased range of motion and mobility
  • Knee stability and function


  • Physical examination
  • X-rays
  • MRI scan

Surgery Repair Procedures

Your ACL surgery is done under a regional or general anesthesia, depending on your constitution and your doctor's recommendation.

  • Several small incisions are made in the knee joint. An arthroscope and other small surgical instruments are inserted into the incisions.
  • A surgical drill is inserted through a small incision. The drill creates holes in the lower end of the femur and upper end of the tibia as anchor points for the graft.
  • The surgeon "harvests" or collects the graft from your hamstring or knee.
  • The graft is inserted and pulled through the two holes or "tunnels" created by the drill and secured in place with sutures or surgical staples or screws.
  • The incisions are closed with tape or stitches and the knee bandaged

What to Expect

Surgery on a torn anterior cruciate ligament is generally performed on an outpatient basis. You should be able to go home and recuperate several hours after the surgery. Surgical repairs of the ACL are done today with an arthroscope, a thin, flexible fiberoptic scope about the diameter of a drinking straw introduced in a very small (about 1/8 inch) incision in the knee joint.