What to Expect From ACL Repair Surgery: Before, During, and After

Tearing an anterior cruciate ligament is a big problem, especially if you are very active or play a lot of sports. The ligament is essential for lateral movements of the legs and can cause a knee to “give out” if such a move is attempted with a torn ACL. Reconstruction of the ligament and the subsequent rehab are quite involved. Here is what to expect:


Expect to receive information regarding diet and what foods can and can’t be eaten prior to surgery. Ordinarily, low fiber foods are suggested the day before surgery, and nothing should be eaten after midnight of the day before surgery. Some form of mild anesthesia is often given shortly before the surgery, and complete sedation is then given just prior to the procedure.

The Surgery

An orthopedic surgeon will make a small incision and insert several arthroscopic tubes into the knee area. Depending on the techniques used and the overall appearance of the inside of the knee, meniscus may be repaired or calcifications removed. Finally, a graft will be attached where the ACL was. Often this is an Achilles tendon from a cadaver, but the patient also has the option of using tissue from his/her own body.


The most challenging part of any ACL repair is the rehabilitation. The average rehab time is between 8 and 12 months. Initially, crutches will be required, but in about a week the patient can begin to apply gentle weight on the affected leg while still using crutches.

During the initial few weeks after the surgery, ice should applied to the knee several times a day, and some doctors also recommend electrical stimulation via a TENS unit. After about a month to six weeks, crutches will no longer be required. At this point, more intensive physical therapy can begin.

Resistance bands, balance exercises, stretching, and gentle strengthening are the next step in rehabilitating the ligament. This can take a very long time, most likely seven or eight months, and requires commitment and patience. Commitment is required to stick with the rehab regimen and patience to keep from trying to do too much too soon.

Once the rehab is done, the affected knee will be as good, or even better, than new. If a torn ACL is limiting activities or causing pain, knee “slippage”, or popping, getting the surgery is well worth the time and effort.