Arthroscopic ACL Reconstruction

Arthroscopic ACL reconstruction is a minimally invasive, “keyhole” surgical technique performed through small incisions using an arthroscope (a thin tube with a camera). This allows the surgeon to visualize the inside of the knee on a screen and carry out the reconstruction with precision, causing less tissue trauma, reduced scarring, and faster recovery compared to traditional methods.

1. Anesthesia and Preparation
   The patient is given general or regional anesthesia to remain comfortable throughout the procedure. The knee is painted  and draped, creating a sterile environment.
2. Arthroscopic Access
   Small incisions (keyholes) are made around the knee. An arthroscope is inserted to provide a clear, magnified view of the joint structures on a monitor.
3. Removal of the Torn ACL
   Damaged ligament fibers and scar tissue are carefully cleared to make space for the new graft. This ensures the reconstructed ligament heals properly without interference.
4. Graft Selection and Harvesting
   The new ligament is formed using a graft, which may be:
   • Autograft – tissue taken from the patient’s own hamstring or patellar tendon.
   • Allograft – donor tissue, sterilized and prepared for surgical use.
     The graft type is chosen based on patient needs, age, activity level, and knee condition.
5. Tunnel Creation
   The surgeon drills small tunnels in the femur and tibia at the exact anatomical position of the original ACL. These tunnels serve as anchor points for the graft.
6. Graft Placement and Fixation
   The graft is threaded through the tunnels and secured with fixation devices such as screws or buttons. The surgeon adjusts the tension so that the new ligament functions like a natural ACL.
7. Final Check and Closure
   Knee stability is tested arthroscopically to confirm correct graft placement. The small incisions are closed with sutures or steri-strips, and a sterile dressing is applied.

Rehabilitation begins almost immediately after surgery and is critical for long-term success. The process is phased and includes:

• Early Phase (Weeks 0–2): Pain and swelling control, use of crutches, and gentle mobility exercises.
• Intermediate Phase (Weeks 2–12): Progressive strengthening of quadriceps and hamstrings, balance training, and stationary cycling.
• Advanced Phase (Months 3–6): Agility drills, plyometrics, and sport-specific exercises.
• Return-to-Sport Phase (Months 6–9+): Functional testing and gradual return to competitive activities.

Arthroscopic ACL reconstruction provides excellent outcomes for most patients. Benefits include:

• Restoration of knee stability and function.
• Reduced pain and faster recovery due to smaller incisions.
• Minimal scarring and lower risk of soft tissue damage.
• Safe return to sports, fitness, and daily activities.

When performed by skilled surgeons and supported with structured rehabilitation, arthroscopic ACL reconstruction allows patients to regain mobility, confidence, and performance within 6–9 months.