What you can expect
General anesthesia is typically used during ACL reconstruction, so you'll be comfortable during the procedure. ACL reconstruction is usually done through small incisions — one to hold a thin, tube-like video camera (arthroscope) and others to allow surgical instruments access to the joint space.
During the procedure
Your surgeon will remove your damaged ligament, and then replace it with a segment of tendon. This replacement tissue is called a graft and it comes from another part of your knee or a tendon from a deceased donor.
Your surgeon will drill sockets or tunnels into your thighbone and shinbone to accurately position the graft, which is then secured to your bones with screws or other fixation devices. The graft will serve as scaffolding on which new ligament tissue can grow.
After the procedure
Once you recover from the anesthesia, you can go home later that same day. Before you go home, you'll practice walking with crutches, and your surgeon may ask you to wear a knee brace or splint to help protect the graft.
Your doctor will give you specific instructions on how to control swelling and pain after surgery. In general, it's important to keep your leg elevated, apply ice to your knee and rest as much as possible.
Medications to help with pain relief include over-the-counter drugs such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Your doctor might prescribe stronger medications, such as meloxicam (Mobic, Vivlodex, others) and gabapentin (Neurontin). If opioids are prescribed, they should be taken only for breakthrough pain as they have many side effects and a significant risk of addiction.
Follow your surgeon's advice on when to ice your knee, how long to use crutches and when it's safe to bear weight on your knee. You'll also be instructed when you can shower or bathe, when you should change dressings on the wound, and how to manage post-surgery care.
Progressive physical therapy after ACL surgery helps to strengthen the muscles around your knee and improve flexibility. A physical therapist will teach you how to do exercises that you will perform either with continued supervision or at home. Following the rehabilitation plan is important for proper healing and achieving the best possible outcomes.