ACL surgery is generally done as out-patient surgery, which means you go home the same day as the operation.  In some cases, if the operation is more complex and other ligaments are reconstructed, patients may stay overnight.  Anesthesia for the surgery involves regional anesthetic with intravenous sedation.  In some cases, a femoral nerve block is used as well, which involves injecting anesthesia around the major nerve to the knee.  No general anesthesia is required for the operation.  The operation is performed by inserting a tendon graft into the knee arthroscopically that replaces the anterior cruciate ligament (ACL).  This graft may be either harvested from the patient (patellar tendon or hamstring tendons) or allograft tissue may be used (usually Achilles tendon transplanted from a donor).  There are pros and cons to all graft choices and the operation is performed in the same manner, regardless of which tissue is used.  Dr. Marx performs the procedure with each of the graft options and decides individually with each patient which is best for them.  The graft is fixed in the knee with the use of screws, ligament buttons and/or staples, depending on which graft is selected. 

After the surgery, the patient is kept in a brace for the first day or two for comfort.  Generally, we recommend discontinuing the use of the brace 1-2 days after surgery.  If the meniscus is repaired (sutured to fix a tear), you will generally be non-weightbearing on the leg for 3 weeks and motion will be limited to 90 degrees for a total of 6 weeks after surgery.  If no meniscal repair is performed and you have had an isolated ACL reconstruction (no other ligament reconstructions), then rehabilitation can start the day after surgery and you can see your physical therapist at 5 days after surgery for your first physical therapy visit.  Physical therapy is then carried out at least twice weekly for several months.  Most patients who have isolated ACL reconstructions can walk normally by 4 weeks and can run and perform agility exercises by 4 months.  Return to sport is between 6 and 12 months.

Risks of surgery include, but are not limited to, anesthesia, infection, re-operation, nerve or blood vessel injury, stiffness, graft rupture, pain with kneeling, deep venous thrombosis (blood clot in the veins of the legs) and pain.