ACL Reconstruction

Before the day of admission it is helpful for you to have read consent information about your procedure and the rehabilitation protocol for ACL reconstruction which will be followed by your physiotherapist following the operation. This information can be downloaded here.  You are usually only in hospital for a day with this procedure.

This procedure is carried out arthroscopically through a telescope which is inserted into your knee through a small cut (keyhole) although in addition you will also have an incision over the upper part of the lower leg which will allow harvest of the hamstring graft and insertion of the graft through the knee. Immediately following your operation an X-ray of your knee will be carried out to confirm the position of the devices used to hold the reconstruction in place.  Clips are used to close the wound and these will be removed 2 weeks after your operation.

Prior to going home Simon will see you and discuss what was found at the time of the procedure. You will also be seen by the physiotherapists who decide whether you need crutches and they will show you the initial exercises you need to practice to maximise your recovery. Prior to your discharge you will be provided with an injection into the abdomen to reduce the risk of deep vein thrombosis and will be provided with anti-embolism (TED) stockings which you should wear for 2 weeks. Occasionally it will be necessary for you to be sent home with further injections to be continued. When you leave you will have a large bandage on your knee and an appointment will have been made for you to return to see the nursing staff after several days for this to be removed. The physiotherapists will also arrange for you to have a physiotherapy follow-up appointment at around a week following your surgery.

It is really important that you continue to do the exercises you were shown in hospital once you get home. You should take regular painkillers if needed - usually a combination of Ibuprofen and Paracetamol is sufficient.

You can return to driving once you feel confident which is approximately a week after your operation. It is really important that you follow the exercises provided in the rehabilitation protocol to ensure that you get a good outcome following your surgery. You should take at least 2 weeks off work. A certificate will be provided by the hospital prior to discharge if you need it. Simon will provide a further certificate when you come back to outpatients if there is any requirement for further time off.

Simon will see you again at the 2-week post-operative stage. He will discuss the findings of your surgery again and will also examine your knee to check the range of movement, the wound, clinically exclude deep vein thrombosis and test stability of the joint. The nursing staff will remove the clips from your wounds at that time. Provided all is well Simon will allow you to increase exercise aimed at strengthening the knee and maximising range of movement but will also recommend that you continue the physiotherapy follow-up.

Further physiotherapy continues up to approximately 3 months following your surgery and is usually on a weekly basis initially increasing to fortnightly when appropriate. Simon will continue to review your progress and you will be seen at the 2-month and 4-month post-operative stage by him. In terms of returning to sport, this will be guided by your overall knee strength and the time following your surgery. In some cases it will be possible to return to sport around 4 months following your surgery but in other cases this will need longer. It takes up to a year for your recovery following anterior cruciate ligament reconstruction to reach an endpoint.

During your recovery slight numbness over the front of the shin is common and initially it is common to experience marked bruising through the calf and into the foot. During recovery the knee often swells after exercise and this can take up to 6 months to resolve.