ACL reconstruction: What to expect and long-term outcomes
Written in association with:
Published: 16/12/2024
Edited by: Aoife Maguire
Anterior cruciate ligament (ACL) reconstruction is a common surgical procedure designed to repair a torn ACL. ACL tears can have a significant impact on mobility and quality of life. A leading orthopaedic surgeon explores what individuals can expect during the recovery process and the long-term outcomes of the procedure.
What is an ACL reconstruction?
An anterior cruciate ligament (ACL) reconstruction is a common surgical procedure performed to repair a torn ACL. The ACL is a key ligament in the knee that provides stability, particularly during activities such as running, twisting, and jumping. When the ACL is damaged—most often due to sports injuries, accidents, or overuse—it can result in instability, pain, and reduced function. ACL reconstruction is often recommended for patients who experience persistent instability or severe impairment despite non-surgical treatments.
What are the typical causes of ACL Injury?
ACL injuries typically occur during high-impact sports or activities that involve sudden changes in direction, forceful contact, or twisting movements. Common scenarios include football, basketball, skiing, or even recreational activities where excessive stress is placed on the knee. Individuals who participate in such activities are at a higher risk, especially those with predisposing factors such as muscle weakness, poor flexibility, or improper technique.
What can you expect during an ACL reconstruction procedure?
The ACL reconstruction procedure involves replacing the torn ligament with a tendon from another part of the body (usually from the hamstring or patellar tendon) or from a donor (allograft). The surgery is performed under anaesthesia and typically takes a few hours to complete. The goal is to restore the stability of the knee and improve function. Following the procedure, patients will experience some discomfort and swelling, which is normal, and pain management is a critical component of the post-operative period.
What is the recovery process like?
Recovery from ACL reconstruction is a gradual process. In the early stages, you may need crutches to support your knee, as weight-bearing will be limited to prevent strain on the new ligament. Physiotherapy plays a significant role in the recovery journey. Through physiotherapy sessions, you will work on regaining strength, mobility, and stability in the knee. Physical therapists often incorporate exercises that improve flexibility, balance, and muscle control to support knee function.
In the first few weeks after surgery, swelling will gradually reduce, and physical therapy will focus on reducing stiffness and promoting range of motion. Over time, strength and endurance exercises are introduced. It is important to follow the guidance of your physiotherapist to ensure a safe return to daily activities and sports.
What long-term outcomes should you expect?
While ACL reconstruction offers excellent results for restoring knee stability, the long-term outcome can vary depending on individual factors such as age, activity level, and adherence to rehabilitation protocols. Most patients experience a return to pre-injury activity levels, but some may need to avoid high-risk activities that put excess strain on the knee. Ongoing maintenance through regular exercise and physical therapy can significantly improve the durability of the reconstructed ligament.
It is essential to continue monitoring the knee's health, particularly if there are any signs of discomfort or reduced function years after surgery. However, for the majority of patients, an ACL reconstruction can lead to significant improvements in knee function and quality of life.