ACL reconstruction overview

ACL reconstruction replaces a damaged and torn anterior cruciate ligament (ACL). The ACL connects the front top of the tibia (the lower leg bone), to the rear bottom of the femur (the thigh bone).

Flow of the ACL reconstruction surgery

Incision made

An incision is made over the front of the knee to expose the patella (kneecap), and the patellar ligament, which holds the patella in place.

Autograft cut

A strip from the patellar ligament and tibia is removed. This section, called an autograph, will be used as a replacement for the damaged ACL.

Arthroscope inserted

The incision is closed. The rest of the ACL reconstruction will be performed with arthroscopic ACL surgery, through small cuts on the sides of the knee. The surgeon uses a small video camera called an arthroscope to see inside the knee and make sure the new ACL is positioned correctly.

ACL removed

With the knee bent, the damaged and torn ACL is cleared away.

Guide pin inserted

A pin is inserted diagonally, from the tibia to the femur. The surgeon will use the pin as a guide to recreate the ACL.

Holes drilled

Using the pin as a guide, the surgeon drills holes in the tibia and femur.

Autograft attached

The autograft is attached to the guide pin. It is pulled through the holes and into place.

End of ACL reconstruction surgery

Special screws secure the bony ends of the autograft to the femur and tibia. The knee is flexed to test the new joint.