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Anterior Cruciate Ligament (ACL) Surgery
In an avulsion fracture, repair surgery is always done as soon as possible.
In reconstruction of a partial or complete tear of the ACL, the best time for surgery is not known. Surgery immediately after the injury has been associated with increased fibrous tissue leading to loss of motion (arthrofibrosis) after surgery.2 Some experts believe that surgery should be delayed until the swelling goes down, you have regained range of motion in your knee, and you can strongly contract (flex) the muscles in the front of your thigh (quadriceps).2 Many experts recommend starting exercises to increase range of motion and regain strength shortly after the injury.
In adults, age is not a factor in surgery, although your overall health may be. Surgery may not be the best treatment for people with medical conditions that make surgery a greater risk. These people may choose nonsurgical treatments and may try to change their activity levels to protect their knees from further injury.
Current research on the surgical treatment of ACL injuries includes different techniques and places to attach grafts; different ways of securing the graft; different types of grafts, such as tendon, muscle, or fascial grafts from your body (autograft); and grafts from a donor (allograft). When choosing a graft, consider the following:
- The success of surgery may be more dependent on the surgeon's skill and preference than the type of graft used.
- A kneecap tendon graft may result in some pain when kneeling.
- The knee functions the same with either a kneecap graft or a hamstring graft.3
- A kneecap graft entails more rehab considerations than a hamstring graft, such as increased pain and swelling that may limit exercises for the thigh muscles for a while.
Complete the surgery information form (PDF) 
(What is a PDF document?) to help you prepare for this surgery.
| By: | Healthwise Staff | Last Revised: May 14, 2010 |
| Medical Review: | William H. Blahd, Jr., MD, FACEP - Emergency Medicine Patrick J. McMahon, MD - Orthopedic Surgery | |
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