Arthroscopic cruciate ligament reconstruction is a surgical procedure in which the damaged ligament is replaced with a graft to improve the stability of the knee joint. In most cases, the procedure involves reconstruction of the anterior cruciate ligament (ACL), which can be injured by a sudden change of direction, twisting of the knee or direct impact.
The procedure is performed through small skin incisions. The surgeon examines the joint using a camera, prepares bone tunnels and inserts the graft, which takes over the function of the damaged ligament. In most cases, the patient’s own tendons are used, such as the hamstring tendons or the patellar tendon. The quadriceps tendon may also be used. The graft is secured to the bone using various fixation devices, such as screws, plates or staples. If other structures, such as the meniscus, are also injured, the surgeon may treat these injuries during the same procedure.
The operation typically takes around one hour, although it may take longer depending on the complexity of the procedure and the presence of any additional injuries. It is performed under spinal or general anaesthesia. Most procedures can be carried out as day surgery, allowing the patient to return home on the same day, once they have recovered from the operation and the medical team has confirmed that it is safe to do so.
Following surgery, a gradual rehabilitation programme begins, with exercises aimed at restoring joint mobility, muscle strength, balance and knee control. Biological healing is an essential part of the recovery process. Over the following months, the graft integrates into the bone and undergoes remodelling, which is why physical loads must be increased progressively.
Returning to sports involving jumping, rapid pivoting and changes of direction often takes between 9 and 12 months after anterior cruciate ligament reconstruction. The decision to return to sport is based on rehabilitation progress and the knee’s functional readiness, rather than solely on the time elapsed since surgery.
