ACL Reconstruction
ACL reconstruction is keyhole (arthroscopic) surgery to replace a torn anterior cruciate ligament — a key stabilizer of the knee — with a graft, usually taken from your own tendon. It is used when a torn ACL leaves the knee unstable or “giving way,” and it aims to restore stability so patients can return to sport and active daily life.
Medically reviewed by the Florence Healthcare medical team · Last reviewed June 2026
Overview
The anterior cruciate ligament (ACL) is one of the main stabilizers of the knee, and a complete tear — common in football, basketball, skiing and other pivoting sports — can leave the joint unstable. Reconstruction is performed arthroscopically through small incisions: the torn ligament is replaced with a graft, most often from the patient’s own hamstring or patellar tendon, positioned and fixed so it behaves like a new ligament as it heals. The surgeon also checks and, where needed, treats associated damage to the meniscus or cartilage at the same time.
Recovery depends far more on rehabilitation than on the operation itself, and a structured, progressive physiotherapy program over several months is what restores strength, control and confidence. For patients travelling from abroad, a dedicated coordinator arranges appointments, a clear treatment plan and a transparent cost estimate before travel, and our orthopedic surgeons can review your MRI and reports remotely first so you understand whether reconstruction is the right step before you travel.
Who is a candidate?
- Active adults with a complete ACL tear whose knee feels unstable or gives way
- People who want to return to pivoting sports or physically demanding work or activities
- Patients with a torn ACL combined with meniscus or cartilage damage that needs treatment
- Those whose instability persists despite a trial of physiotherapy and activity changes
- People fit enough for surgery and committed to a months-long rehabilitation program
What happens
- 1
Assessment and planning
An examination and MRI confirm the ACL tear and any associated meniscus or cartilage injury, and you and your surgeon choose the graft type. Imaging and reports can be reviewed remotely before travel.
- 2
Prehabilitation and preparation
Reducing swelling and regaining range of motion and quadriceps strength before surgery (prehabilitation) improves the outcome. Your team optimizes your health, plans the anesthetic, and explains the recovery ahead.
- 3
The operation
Under anesthesia and through small keyhole incisions, the surgeon removes the torn ligament, prepares the graft, positions it in bone tunnels and fixes it securely. Any meniscus or cartilage damage is addressed in the same session.
- 4
Early recovery
Most patients go home the same day or after one night, walking with crutches and often a brace. Early physiotherapy focuses on reducing swelling, restoring movement and reactivating the muscles.
- 5
Progressive rehabilitation
A staged program over several months rebuilds strength, balance and sport-specific control before any return to pivoting sport. International patients receive a clear rehabilitation plan and can be supported remotely after returning home.
Benefits
- Restores knee stability and stops the knee giving way
- Allows most patients to return to sport and active, demanding activity
- Keyhole (arthroscopic) technique means small incisions and a smoother early recovery
- Protects the meniscus and cartilage from further damage caused by an unstable knee
- Lets associated meniscus or cartilage injuries be treated at the same time
- Improves day-to-day confidence in the knee for work and activity
Risks & considerations
- Infection, bleeding and blood clots, as with any surgery
- Knee stiffness or difficulty regaining full movement, which rehabilitation works to prevent
- Graft failure or re-tear, particularly with an early or unguarded return to sport
- Pain, weakness or numbness at the site where the graft was taken
- Ongoing instability or further meniscus or cartilage problems in some patients
- A long, demanding rehabilitation before return to full sport
Conditions this treats
Where it is performed
This procedure is delivered by our Spine Center & Orthopedics.
Learn more before you decide
Provider-reviewed guides on the related conditions, symptoms and tests in our Health Library.
ACL Reconstruction — frequently asked questions
Not always. Some people manage well with physiotherapy alone, especially if they avoid pivoting activities. Reconstruction is usually advised when the knee remains unstable or gives way, when there is associated meniscus damage, or when you want to return to sport or demanding work. Your surgeon advises after reviewing your MRI and examination.
Return to pivoting sport is typically around nine to twelve months and is guided by strength, control and confidence rather than time alone. Returning too early raises the risk of re-tear, so progression follows rehabilitation milestones agreed with your physiotherapist and surgeon.
ACL reconstruction is often a day case or a single overnight stay, but you should plan additional days locally for the first physiotherapy and review; your coordinator confirms the timeline. We provide a transparent, itemized cost estimate after reviewing your case — covering assessment, surgery, the graft and follow-up — rather than quoting fixed prices online, because each plan is individual.
Yes. Send your knee MRI and reports and our orthopedic surgeons give an independent opinion remotely on whether reconstruction is needed, which graft suits you and whether other damage needs treating, so you can decide before travelling.
Most reconstructions use a graft from your own hamstring or patellar tendon, which integrates reliably. The choice depends on your anatomy, activity goals and surgeon’s assessment, and is discussed with you beforehand; donor (allograft) tissue is used only in selected cases.
Most patients use crutches in the early days and may wear a brace for a period, both of which are part of the standard recovery. Your physiotherapist guides when to reduce support as strength and control return.
Related treatments
Considering acl reconstruction?
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