Knee Reconstruction is an operation to reconstruct (Replace) torn knee ligaments in the knee. Ligament injuries requiring reconstruction occur in younger active patients, most commonly, but not always, as the result of a sporting injury.The commonest ligament injury requiring reconstruction is a rupture of the Anterior Cruciate Ligament.(ACL)

The ACL is a large strong central ligament in the knee joint, providing stability for pivoting, twisting and rotational movements. It is very important to be able to run and turn for sports such as football, netball, basketball, tennis, squash etc. Severe ACL instability will cause the knee to give way even for daily living activities. It is a greater disability to the younger sporting and active patient, and recurrent instability will stop participation in sport, and lead to progressive damage to the joint, such as tearing of menisci (Cartilages). Knee reconstruction is advised for significant instability symptoms.

 ACL reconstruction is performed in a hospital operating room under a General anaesthetic.It is done with arthroscopy assistance. A tendon is harvested to use as a graft for the torn ACL. Simply suturing the torn ligament ends does not work. The graft is inserted into prepared tunnels in the tibia and femur, using the arthroscope to visualize the internal knee anatomy, and to guide tunnel placement and graft insertion into the approximate sites of the previous ACL attachments to these bones in the knee joint. Special surgical devices are used to fix the tendons into the bones until they heal and take over the function of the ACL.

The operation can take 1-2 hours, and patients will be hospitalised for 2-3 days after operation. A splint is used post-operatively for 6 weeks, crutches are needed for 2 -3 weeks, and there is an extended physiotherapy program to regain knee function. Most patients will be able to return to work in 2 -3 weeks, but return to competitive sport takes more than 12 months. This is necessary to allow the new graft time to heal, and become incorporated into the knee, and to allow the muscles and joint function to fully recover.

The operation is generally very successful, but 10- 15% of patients will require further operations for cartilage injuries or reinjury to the ACL graft in the future. Some sportsmen will not be able to return to competition at the level they participated prior to their ACL injury. There is an increased risk of later Osteoarthritis of the knee in patients who have suffered an ACL rupture.