ACL / Cruciate ligament reconstruction

Before surgery, the patient undergoes orthopedic and anesthesia consultations and completes the requested laboratory and imaging tests. Magnetic resonance imaging of the knee is usually reviewed, and X-rays or other examinations may be required in selected cases.

The medical team should be informed about chronic conditions, allergies, previous operations, and all medications and supplements. Medications that affect blood clotting must only be stopped or modified on the doctor’s instructions.

Prehabilitation is often recommended to reduce swelling, restore as much range of motion as possible, and strengthen the muscles before surgery. Good preoperative knee function may support the early stages of postoperative rehabilitation.

Rehabilitation begins in the early postoperative period. Initial goals include controlling pain and swelling, protecting the graft, gradually restoring knee extension and flexion, and activating the muscles. Weight-bearing, the duration of crutch use, and the possible use of a brace are determined by the surgeon according to the reconstructed ligament and any additional procedure, such as meniscus repair.

Later stages include strength and stability training, proprioception, gait training, and eventually dynamic and sports-specific exercises. Return to work, driving, and sports is individualized. Clearance for sports should be based on medical assessment, functional testing, muscle strength, neuromuscular control, and knee stability rather than time alone.

KCM Clinic patients may continue postoperative physical therapy at KCM Clinic and receive a 10% discount on rehabilitation.

Reconstruction may be considered in patients with:

• a complete or extensive ACL injury with symptomatic instability,
• a significant PCL injury causing knee instability,
• recurrent episodes of the knee giving way or twisting,
• instability that interferes with work or daily activities,
• a need to return to sports involving pivoting, braking, and rapid changes of direction,
• associated injury to other ligaments, the meniscus, or articular cartilage,
• insufficient improvement after appropriately conducted nonsurgical treatment.

Final eligibility is determined by an orthopedic surgeon based on the medical history, physical examination, and imaging results.

What Outcomes May Be Expected?

The goal of reconstruction is to improve knee stability and reduce symptoms caused by ligament insufficiency. Together with a structured rehabilitation program, the procedure may improve limb control, confidence during walking, daily function, and the ability to return gradually to physical activity.

The result develops over time and depends on the type of injury, the condition of the cartilage and menisci, the graft used, healing, adherence to rehabilitation, and compliance with activity restrictions. Surgery does not guarantee a return to the previous level of sports performance and does not eliminate the risk of reinjury.

What Type of Graft Is Used for Reconstruction?

The patient’s own hamstring tendons, part of the patellar tendon, or the quadriceps tendon are commonly used. Donor tissue may be considered in selected cases. The choice is discussed during qualification.

How Long Will I Need Crutches or a Brace?

The duration is individualized. It depends on whether the ACL or PCL was reconstructed, graft fixation, and any additional procedure performed in the knee.

When Can I Return to Sports?

Return to sports is considered after adequate mobility, strength, stability, and neuromuscular control have been restored. For many patients this takes many months, but clearance should not be based on time alone.