The anterior cruciate ligament (ACL) keeps your knee stable when you twist, turn or land. A torn ACL is one of the most common sports knee injuries, and not everyone needs surgery to get back to an active life.
Not always. The right choice depends on how unstable your knee feels, the sports and work you want to return to, and whether other structures such as the meniscus are damaged.
ACL reconstruction is keyhole (arthroscopic) surgery, usually as a day case or with one night in hospital. I replace the torn ligament with a graft, which is passed through small tunnels drilled in the thigh bone and shin bone and fixed in place while it heals into the bone. Any meniscal tear is treated at the same time where possible.
There are three main types of graft. Each has advantages and drawbacks, and none is right for everyone. I will recommend the graft that best suits your knee, your sport and work, and any previous surgery.
One or two hamstring tendons are taken through a small cut on the inner side of the shin.
The middle third of the patellar tendon is taken with a small block of bone at each end (bone-patellar tendon-bone).
Tissue from a screened tissue donor, so nothing is taken from your own knee.
Depending on what I find at examination, on the scan and during surgery, additional procedures may become necessary at the same operation.
These procedures can alter your routine rehabilitation. For example, after a meniscal repair you may need a brace or protected weight bearing for the first weeks. I will explain your plan after surgery, and your physiotherapist will follow the protocol for the procedures you had.
Every recovery is different. Your physiotherapist and I will adjust your plan as you progress.
Most people recover well. As with any operation there are risks, including infection, blood clots, stiffness, numbness around the scar and graft failure or re-injury. I'll talk these through with you so you can make an informed decision.
Ideally within a few weeks, especially if your knee is locking or you may have a meniscal tear, which is easier to repair early.
Not necessarily. I can arrange a scan after examining you, which avoids paying for one you don't need.
Usually 2 to 6 weeks after surgery, depending on which knee was operated on and when you can do an emergency stop safely.
Self-pay prices are confirmed at your consultation. Most insurers cover ACL reconstruction; check with yours before booking.
Written and reviewed by Mr Mathias Nagy, FRCS (Tr & Orth). Last reviewed November 2026.