AnteriorCruciate Ligament (ACL)is the primary stabiliser of the knee. It prevents instability and buckling of the knee while doing activities of daily living. It acts as a primary restrain to anterior translation of the leg bone. The usual primary mode of injury to the ACL is during a vigorous sporting activity or an accident.

The key hole (arthroscopic) techniques have transformed ACL surgery and its results. There has been a tremendous improvement in outcomes of surgery. The surgery is done using an arthroscope making use of small incisions.

The torn ligament is reconstructed using grafts from the same or opposite limb with a wide variety of options available. The surgery is done under spinal/regional anaesthesia and takes about an hours’ time.The graft is fixed at both ends using different implants depending on preference of the patient and the surgeon.

The patient is allowed orally from the evening of the surgery and made to ambulate with aid the next day onwards. The patient is guided through in bed exercises for better & faster rehabilitation.

ACL Surgery ~ The key hole arthroscopic techniques have transformed ACL surgery and its results. There has been a tremendous improvement in outcomes of surgery. The surgery is done using an arthroscope making use of two small incisions. The torn ligament is reconstructed using grafts from the same or opposite limb with a wide variety of options available. The surgery is done under spinal/regional anaesthesia and takes about an hours’ time.The graft is fixed at both ends using different implants depending on preference of the patient and the surgeon. The patient is allowed orally from the evening of the surgery and made to ambulate with aid the next day onwards. The patient is guided through in bed exercises for better & faster rehabilitation.

Physiotherapy remains an important concern which predicts outcome of surgery.

Phase 1 aims at full extension and up to 90 degrees of flexion. Use of ambulatory aids like crutches and knee immobilizer is discontinued after two weeks and patient walks unaided hence forth.

Simultaneously the Rehabilitation programme phase 2 starts from the day of suture removal. It focusses on achieving range of motion of up to120 degrees. After this at about 12 weeks, phase three starts where the focus remains on strength training. All the previous exercises are added up each time and at about 4 months, proprioception and balance training starts.

The patients usually get back to normal activities of daily living by 6 weeks’ time and back to sports by about 6 months. All patients do not have same response to pain and exercises. The course varies with each individual and no two cases are the same. The cartilage and meniscal injuries associated with the ligament tear define the prognosis of the patient to great extent.