Anterior Cruciate Ligament (ACL) Reconstruction
What is ACL reconstruction?
The anterior cruciate ligament (ACL) is one of the main stabilising ligaments of the knee, preventing forward translation and controlling rotation of the tibia on the femur. ACL rupture typically occurs during pivoting or jumping sports and results in knee instability, recurrent giving way and an increased risk of further injury to the meniscus, cartilage and other ligaments.
ACL reconstruction is the procedure of choice for most active patients, particularly those who wish to return to pivoting sports or who experience ongoing instability. The torn ACL is not repaired directly; instead, it is reconstructed using a tendon graft placed at the anatomic origin and insertion of the native ACL.
ACL reconstruction is typically performed using minimally invasive (arthroscopic) techniques. The damaged ligament is replaced with a graft, often taken from the quadriceps tendon, to restore stability and function to the knee. In selected patients, an additional procedure may be performed to further reduce the risk of re-injury.
Who is suitable?
ACL reconstruction is indicated for:
Dr Stoita will review your symptoms, activity goals, and any existing imaging. A detailed clinical examination is performed to confirm the diagnosis and discuss whether this procedure is the right option for you.
Initial visitX-rays, MRI or other imaging may be used to confirm the diagnosis and assess the extent of the condition. In complex cases, 3D computerised modelling may be used to assist with surgical planning.
Pre-surgeryThe procedure is performed under anaesthesia using the most appropriate surgical technique for your condition. Dr Stoita uses minimally invasive approaches where possible to reduce recovery time and optimise outcomes.
Day of procedureFocus is on pain and swelling control, full passive extension, progressive flexion and quadriceps activation. You will be partial weight bearing with crutches during this phase.
Most patients progress to full weight bearing, achieve full range of motion and begin gait normalisation and closed chain strengthening exercises during this phase.
Rehabilitation progresses to strengthening, proprioception training and low-impact conditioning. This phase builds the foundation needed for sport-specific activity.
Running progression, sport-specific drills and cutting and pivoting movements are introduced under controlled conditions. Your physiotherapist will guide the pace of this phase based on your progress.
Return to pivoting and contact sport is guided by successful completion of return-to-sport testing, not just time. Dr Stoita's approach prioritises readiness over rushing, protecting the long-term health of your knee.
With a quadriceps tendon autograft combined with lateral extra-articular tenodesis and a structured rehabilitation program, return-to-sport rates of 80–90% and re-rupture rates under 5% are achievable in properly selected patients.
Frequently Asked Questions (FAQ)
Diagnosis involves understanding a history of your symptoms, examining your knee, and using imaging such as X-rays to assess cartilage wear and joint alignment. In some cases, additional scans such as CT or MRI scans may be required to either exclude other conditions or quantify the degree of arthritis.Some patients develop patellofemoral pain syndrome in the absence of any bone, joint or soft tissue abnormalities. However, most patients with the syndrome present with one or more abnormalities related to bone anatomy, joint anatomy and/or soft tissue.
Diagnosis involves understanding a history of your symptoms, examining your knee, and using imaging such as X-rays to assess cartilage wear and joint alignment. In some cases, additional scans such as CT or MRI scans may be required to either exclude other conditions or quantify the degree of arthritis.Some patients develop patellofemoral pain syndrome in the absence of any bone, joint or soft tissue abnormalities. However, most patients with the syndrome present with one or more abnormalities related to bone anatomy, joint anatomy and/or soft tissue.
Although knee arthritis can affect anyone, there are several factors that can increase the risk of arthritis:
- Genetic predisposition
- Previous knee injury or surgery
- Other joint conditions such as rheumatoid arthritis or gout
- Occupations involving heavy manual work
- Age (over 40)
- Female gender
- Being overweight or obese
- Participation in high impact activities or sports (e.g. running, soccer or rugby)
Knee arthritis typically develops as a result of progressive cartilage wear within the joint. This process may occur naturally with age or be accelerated by factors such as previous injury, altered joint alignment, or increased mechanical load.
In some cases, inflammatory conditions such as rheumatoid arthritis can also contribute to joint degeneration.
