Anterior Cruciate Ligament (ACL) Reconstruction

ACL reconstruction is one of the most common surgical procedures performed on the injured knee.

The anterior cruciate ligament (ACL) is one of the four major stabilising ligaments of the knee. Its anatomical attachments allow it to resist anterior translation and internal rotation of the tibia (shin bone), in relation to the femur (thigh bone).

ACL tears are one of the most common knee injuries. Most are a result of landing or planting in cutting or pivoting sports, with or without contact. If a complete tear is diagnosed an ACL reconstruction is usually recommended, because the ACL is crucial for stabilizing the knee when turning or planting.

What is an ACL reconstuction?

An ACL reconstruction is one of the most common surgical procedures performed on the injured knee.

The ACL is an intraarticular (within the joint) ligament, and as such heals poorly.  For this reason, it is almost always reconstructed with a substitute ligament, rather than being repaired.

There remains disagreement as to which tissue graft best reproduces the internal stability of the knee.  There is currently no gold standard method of grafting recognised by research literature. The most common are:

• Hamstring tendon graft: a strip of accessory hamstring tendon on the inner aspect of the lower thigh is removed and folded over for strengthening. It is then fixated with screws within holes drilled in the tibia and femur. Click here to view a 3D ACL reconstruction animation using a hamstring graft.

• Synthetic graft (LARS reconstruction): an industrial strength polyester woven fibre is grafted arthroscopically without the further invasive harvesting of tissue from other parts of the body. It boasts quicker recovery times as well as less pain, swelling and restriction. However, it is yet to be validated with evidence from the literature.

At the time of surgery, the ruptured ACL is removed and the graft is placed anatomically and held with screws and occasionally a staple.

How can ACL reconstruction help?

The rationale for surgery is to stabilise an unstable joint, or a potentially unstable joint. Joint stabilisation has been shown to decrease meniscal and articular cartilage injury. This should, in turn, decrease the incidence of later osteoarthritic change. It will also allow return to activities that were difficult secondary to joint instability.

Is physiotherapy required before ACL reconstruction?

Ideally before you have an ACL reconstruction pre-habilitation should be carried out under the guidance of one of our physiotherapists. This will allow improved strength and flexibility of your knee leading into the surgery and ultimately a quicker and better post-operative result.

How long will it take to recover?

Unless instructed otherwise, patients can bear as much weight on the leg as comfort allows immediately after the surgery. Crutches may be used for comfort where necessary, and are usually required for 2-3 days. Most people are walking reasonably comfortably by 2 weeks. It is important not to over-exert too early after the procedure as this can increase discomfort and swelling. Other activities can be gradually reintroduced within ones level of comfort. Driving is allowed as soon as safe to do so. People with desk jobs can return to work as early as 1-2 days, while people in more heavy manual employment may require 6 weeks.

The rehabilitation program runs over a 6-12 month period prior to returning to competitive sports or unrestricted activity.

 Is physiotherapy required after ACL reconstruction?

Yes.  Our physiotherapists will play a large role from the early stages post-operatively. Rehabilitation following ACL reconstruction is an essential part of full recovery. We will be able to guide you through your rehabilitation and tailor guidelines to your abilities and needs as you progress. The  end stages of rehabilitation are when important decisions on return to sport are made. These are determined by clinical examination techniques that are high predictors of re-­‐injury risk. This maximises the chances of a successful return to sport and activity.

All rehabilitation programs are flexible. Individual progress varies greatly, and this will require some modifications of the program at the discretion of the physiotherapist.

What are the risks?

ACL reconstruction is a very safe procedure. The most common side effect of ACL reconstruction is temporary discomfort or slight bruising. Due to the skin incision patients may notice a numb patch on the outer aspect of their leg past the skin incision. This is of no functional significance and is unavoidable. The numb patch tends to shrink with the passage of time and does not affect the result of the reconstructed ligament.

Graft failure due to poorly understood biologic reasons occurs in approximately 1% of grafts.

As with all operations if at any stage anything seems amiss it is better to call up for advice rather than wait and worry.

For more information regarding ACL reconstructions or the rehabilitation involved before or after surgery contact one of the physiotherapists at Jubilee Sports Physiotherapy.

Share this post

Hi, would you like to chat with one of our physios?

Please provide your contact details and one of our experienced physiotherapists will give you a free, no obligation call to assist you with your query. 

m mooney
m mooney
04:59 09 Jul 24
Julie Dimevski
Julie Dimevski
08:04 26 Jun 24
Kieran and the team have provided great customer service during my daughters recovery. They show care, and are supportive. He has been open and transparent, and positive. Thanks Kieran and team.
Tim merchant
Tim merchant
06:42 23 Apr 24
Really inviting staff, always ready to help. They know what they are talking about and facilites are wonderful.
Ashley Williams
Ashley Williams
10:55 03 Apr 24
best in the business the team here are the very best at their jobs
G G
G G
16:52 05 Mar 24
I came to Jubilee Sports Physio for help on how to exersise and get fit without injuring myself constantly.During my initial consultation Michael said, I was standing wrong, sitting wrong and exersises I did were not suitable for my body.After four sessions, 15 minutes of daily exercises in between and I can go on hikes, lift weights and feel many years younger.I now have the life I want and very grateful to Jubilee Sports Physio, for their professionalism from booking, greeting and being able to do all I want physically.I highly recommend Jubilee Sports
Lara Mangelli
Lara Mangelli
08:56 18 Dec 23
I would like to express my sincere appreciation for the exceptional care provided by Michael and James for attending to my son, both before and after his shoulder reconstruction. Michael and James' combination of kindness and professionalism played an important role in helping my son navigate through what was his first significant life challenge.They both demonstrated an unwavering commitment to my son's well-being, providing not only expert physiotherapy but also a level of compassionate support that went above and beyond.Thank you Jubilee team for your outstanding commitment to patient care. It's reassuring to know that professionals like Michael and James are dedicated to not just addressing physical challenges but also fostering a supportive and empathetic environment for individuals facing health setbacks. The receptions ladies were kind and helpful too.
Judith Gifford
Judith Gifford
06:00 18 Dec 23
Over a period of 4 years my husband and I have had the expertise and professionalism of Michael Gabriel and staff at Jubilee Sports Physiotherapy Each of our ageing conditions required commitment to exercises to improve. When the conditions were clearly explained we gained confidence and understanding of realistic outcomes. We feel very fortunate for all of our treatments..and highly recommend Michael and staff.
Georgia Manos
Georgia Manos
12:08 13 Dec 23
The whole Jubilee team is fantastic. They are professional, knowledgeable and have always gotten me back playing football as quick as possible!
Jordan Figon
Jordan Figon
06:36 13 Dec 23
The team at Jubilee have been looking after me for over 15 years. Specially Michael with the help of Kieran. They have rehabbed me through 4 major surgeries as well as long standing injuries. It is because of these guys, I am able to still be involved in the game I love, stretching my career out as long as possible. In addition, my whole family is part of the Jubilee family
David Washington
David Washington
05:02 13 Dec 23
I have relied on Michael Gabriel for my physiotherapy needs for a number of years now. His professional work has allowed me to continue to chase the love I have for outdoors recreation.
Luke Payne
Luke Payne
22:05 12 Dec 23
Michael and his team are the best. So professional and knowledgeable and have kept me moving for years.
Diane sutton
Diane sutton
21:58 12 Dec 23
I have been a patient of Jubilee Sports Physio for many years, being treated for various injuries & chronic conditions. Michael’s diagnostic skills are excellent. I can highly recommend this practice for their care, proficiency & friendliness.
Nicole Simpson
Nicole Simpson
10:53 12 Dec 23
Micheal has helped over the years to heal and help with my injuries.. The entire team gives a five star help. I can’t praise them enough…Thank you so much
Judy Andrews
Judy Andrews
10:26 12 Dec 23
Michael has treated me on a number of occasions. He is very professional and very easy to talk to. He obviously knows his stuff and never fails to set you on the right path with his treatments
BERGE GABO
BERGE GABO
09:28 12 Dec 23
"I have been going to Jubilee Physiotherapy for many years.Very professional from the receptionists to the principal Physioswith lots of experience and straight to the point thatsave time and money"
Corinne Favaloro
Corinne Favaloro
04:09 02 Nov 23
I have been attending Jubilee physio, on and off, for many years.In fact three generations of my family are presently receiving treatment there. I have had several of the physiotherapist at Jubilee work on different problems and have found them all to be professional, knowledgeable and very caring in their treatment.
Nicole Di noia
Nicole Di noia
22:19 01 Nov 23
Thorough, professional and passionate team of physiotherapists.
Steve Chidgey
Steve Chidgey
02:04 04 Jul 23
The the treatment I received for injury was first class. Caring, knowledgeable and highly professional. The electronic home exercising provided to me showed me the required exercises so I was not let to a piece of papers directing me. Loved the app. This physio is the best I have used. Highly recommended.
Margaret Peace
Margaret Peace
01:29 01 Jul 23
I have attended Jubilee Physiotherapy for many years and have always had a positive experience. The staff are professional and knowledgeable. I always feel comfortable and safe in their care.My therapist, Samuel Leslie, knew exactly how to treat my new neck issue. As a result, I have made a very good recovery.
Angelina Mastoris
Angelina Mastoris
23:09 01 Mar 23
The guys at Jubilee are amazing! Been going for a couple years and each time I’ve had a great experience. Massive shout out and thanks to our team Physio Sam for helping me with my rehab and recovery. He’s helped improve my overall game and has made me stronger than before. He’s a legend. Would highly recommend, overall fantastic experience!
See All Reviews
js_loader

Hi, would you like to chat with one of our physios?

Please provide your contact details and one of our experienced physiotherapists will give you a free, no obligation call to assist you with your query.