HealthInfo Canterbury
Surgery for an ACL injury
Pokanga mō te nape rīpeka o mua
If you've completed a rehabilitation programme with a physiotherapist but your knee is still unstable, it's likely you'll need surgery.
An orthopaedic surgeon will assess your knee and tell you if they recommend surgery. As well as having an unstable knee, other reasons you could need surgery include:
- you're nervous about movement
- you feel that you have some disability, or your knee stops you from doing things that are important to you
- you plan to return to sports that involve a lot of pivoting and twisting
- you don't have full movement (extension)
- you still have swelling and a weak thigh.
Before surgery
It's best not to have surgery immediately after an ACL injury. The results are better after your knee has had time to settle down and you've strengthened your leg with a rehabilitation programme.
Surgery
Surgery to reconstruct your ACL can be done in a few ways. This page from the NHS website in the UK explains the types of surgery.
After surgery
After surgery, you'll need to follow the surgeon's instructions carefully until you see your physiotherapist one or two weeks later. Your physiotherapist will then give you another exercise programme to get your knee working properly again and strengthen your leg.
It will take at least six months and maybe as long as a year to fully rehabilitate your knee so it's essential that you follow your physiotherapist's instructions and do all the exercises. If anything is stopping you from doing the exercises, talk to your physiotherapist about it.
After surgery and completing an exercise programme:
- 82% of people return to sport of some kind
- 63% of people can use their leg as well as they did before the injury
- only 44% of people return to competitive sport, which is largely because many people are worried about injuring their knee again.
Young athletes are more likely to return to sport after surgery.
People often worry about developing arthritis after an ACL injury. As long as you didn't hurt anything else other than your ACL, the risk of arthritis is low. But your risk increases if you also damaged other parts of your knee, if you haven't been able to get normal movement back after rehabilitation or surgery or if you're overweight.
Even after surgery and the later exercise programme, 12% of people injure their knee again. So, it's important to follow a programme to avoid that.
Written by a Christchurch physiotherapist. Adapted by HealthInfo clinical advisers. Last reviewed July 2022.
SourcesReview key: HIHIL-240273
