An ACL injury can sideline your game and make you hit pause on your regular activities. When you need surgery to repair a torn ACL, UPMC Sports Medicine is here for you.
For more than three decades, we’ve been a leader in ACL reconstruction surgery and knee injury treatment. We take a personalized approach to ACL surgery, which helps get the best possible results for you.
Through our dedicated ACL Program, all we do is treat ACL injuries. In repairing your ACL tear, we have two main goals:
We have an entire team ready to help see you through ACL surgery, from orthopaedic surgeons to physical therapists, performance coaches, and nutritionists.
ACL surgery repairs a tear in your anterior cruciate ligament, which is one of four ligaments in your knee joint. The ACL connects your shin bone to your thigh bone and helps stabilize your knee.
ACL injuries, called ACL tears or ruptures, are common among athletes.
If you only tear the ACL partially, you may not need surgery. Sometimes, physical therapy and bracing can help it heal.
For a full ACL tear, you may need surgery to build the ACL. The surgeon uses a graft — a piece of tissue from either your own body or from a donor — to do this.
At UPMC, we do nearly all ACL surgeries arthroscopically, because our orthopaedic surgeons have advanced training in this less invasive technique. It allows us to make very tiny cuts and use a small camera and small instruments to repair the ACL.
ACL surgery is typically an outpatient surgery. But since it involves harvesting grafts from other parts of your body, it's still considered major surgery.
To repair a torn or ruptured ACL, your surgeon will discuss graft options with you. We can:
Your knee surgeon chooses whichever graft will give you the strongest possible tissue, so you can:
An autograft most often comes from your patellar, quadriceps, or hamstring tendon.
Your surgeon will decide which tendon to use based on:
If you’re not a good fit for an autograft, you can have an allograft. Your knee surgeon will discuss the best options for you based on your:
Most people with serious partial and complete ACL tears are good candidates for ACL surgery. The surgery is especially beneficial if you're:
You may also have other knee damage from your injury that only surgery can fix. About half of ACL injuries involve damage to the meniscus or other ligaments, too.
Once you decide to have surgery, your surgeon may recommend waiting. Research shows that waiting two weeks to two months leads to better outcomes. It allows your knee to:
Your surgeon will talk with you about the best timing for ACL surgery based on your injury and overall health.
ACL surgery is very effective, giving you a stable knee again. But as with all surgeries, it comes with risks, including:
Your surgeon will give you medicine to help reduce those risks.
Other risks and complications of ACL surgery include:
If you follow your surgeon’s instructions before and after surgery, you can reduce your risk of these complications.
Before surgery, your UPMC Sports Medicine knee surgeon will design a complete plan based on:
Your surgeon will also discuss the recovery time after ACL surgery, so you fully understand your rehab plan.
Before surgery, your doctor may order tests to help us learn more about your injury. These tests may include x-rays and MRI scans to take precise measurements of the bones and structures of the knee.
Your test results help your surgeon:
The timing of these tests depends on a few factors, such as swelling in your knee. Your swelling may need to go down so your doctor can get a clearer picture of the injury and nearby areas.
Before surgery, doctors often prescribe physical therapy, or “pre-habilitation.” Pre-hab can help to:
Your doctor will discuss what types of exercises would be good for you to do before surgery.
At the UPMC Sports Medicine ACL Program, we counsel people who need help with their nutrition needs before having surgery.
We may suggest that you:
ACL surgery is usually outpatient surgery, so most people go home the same day they have surgery.
Your surgeon will talk to you in detail about the surgery and explain each part. There are generally four steps to ACL surgery.
You’ll meet with an anesthesiologist before surgery. Together with your surgeon, they’ll decide which type of anesthesia is best for you. Types include:
Your surgeon will likely use an arthroscope to look at your knee joint and injured ACL to confirm:
If the surgeon is using an autograft to repair your ACL, they’ll harvest the graft from a tendon in either your:
Your surgeon will make a cut at the harvest site, extracting part of the tendon that will become your new ACL. They’ll only take the amount you need.
To reconstruct your ACL using the graft tissue, your surgeon will:
Depending on your case, you may have other damage in your knee. Your surgeon will make any other necessary repairs before finishing surgery and closing your incisions.
Most ACL reconstruction procedures take two hours or less. The time depends on:
After surgery, you'll move into the recovery room. Your care team will check to make sure you don't have any problems from the surgery and anesthesia.
When you're ready to go home, your surgeon and care team will go over discharge instructions. Your doctor will also send you home with medicine or advice for managing pain.
You may need someone to help you when you first go home from ACL surgery. You can expect to be off work for a few days to a few weeks, based on how physically demanding your job is.
For the first two weeks after surgery, you'll need to:
You can usually move your knee right after surgery, but it might hurt. Your doctor will give you exercises to do to keep the blood flowing in your leg and help prevent blood clots.
It's crucial you work on quad sets. Quad sets will ensure your knee heals fully straight and you won’t get a contracture later on.
You'll likely use a continuous passive motion machine, so your knee gets regular movement.
About two weeks after surgery, you:
Your surgeon will do a physical assessment of the repaired knee to measure the range of motion and stability. They might fit you for a knee brace to wear for a few weeks.
If the incision is healing properly and you have no complications from surgery, you’ll start physical therapy.
Most people get back to full activity within six to 12 months. This part of the recovery is all about physical therapy. Your PT exercises will help you regain strength and stability in your knee.
At UPMC Rehabilitation Institute, we have injury- and sport-specific PT programs.
Your surgeon and physical therapist will work together to clear you for a safe return to your full, daily routine or sport. At UPMC, we have a Return-to-Play Program for athletes with ACL injuries.
At any time during your recovery, call your doctor right away if you have:
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