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Learning About Anterior Cruciate Ligament Reconstruction Surgery

What is anterior cruciate ligament surgery?

The anterior cruciate ligament (ACL) is one of four knee ligaments that connect the upper leg bone (femur) with the lower leg bone (tibia). When you injure or tear your ACL, your knee is less stable. It may "give out" when you do not expect it and then become stiff and swollen.

Surgery can help your knee feel better. But in some cases, the knee may not be as strong as before it was injured.

This type of surgery replaces your damaged ACL with a new one. The new one is called a graft. Most of the time, the graft is a tendon taken from your own knee or hamstring. But it may come from a donor.

After surgery, most people can return to their normal activities.

How is ACL surgery done?

Your doctor makes several small cuts (incisions) around the knee. Then the doctor puts a lighted tube, called an arthroscope or scope, into one of the incisions. A camera at the end of the scope sends pictures from inside the knee to a TV monitor in the operating room. The doctor watches the monitor to do the surgery.

The doctor puts surgical tools through the other incisions. Small holes are drilled into the upper and lower leg bones where these bones come close together at the knee joint. The holes form tunnels for the graft. The doctor takes the graft and pulls it through these tunnels. Then the doctor attaches the graft with screws or staples.

Next the doctor closes the incisions with stitches or tape. And you may get a temporary surgical drain placed in your knee.

You will not feel pain during the surgery. You will get medicines to make you sleep or to numb your leg.

Your doctor also may repair other injured parts of your knee. These may include ligaments, cartilage, or broken bones.

What can you expect after ACL surgery?

After you recover, you should have less pain. And your knee should be more stable.

How soon you can go back to work depends on your job. If you sit at work, you may be able to go back in 1 to 2 weeks. If you are on your feet at work, it may take 4 to 6 weeks. If you are very physically active in your job, it may take 4 to 6 months.

A rehabilitation (rehab) program can help your knee get better faster.

  • Your rehab may start before surgery. Your doctor or physiotherapist may recommend strength and motion exercises to prepare for surgery.
  • After surgery, you will do exercises as part of your rehab program. This often lasts up to a year.
  • Rehab is hard work. Many people say it feels like "having a second job."

If you commit to your rehab and work hard, you will see a lot of improvement in a few months. Within a year, you should be able to do all the activities you did before. This includes playing sports. But you may have to wear a brace when you play sports.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Where can you learn more?

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