An anterior cruciate ligament reconstruction is an operation to replace a damaged anterior cruciate ligament with a ligament graft or a synthetic ligament.

ACL reconstruction with Graftlink

Anterior cruciate ligament reconstruction using the 'all-inside' method

Guide for all-inside ACL reconstruction

Guide for Drilling the femoral tunnel for an all-inside ACL reconstruction.


Graft options for ACL reconstruction

There are two common options for the graft material:

  • Autograft - using the patient's own tissues for the reconstruction
  • Allograft - using donor tissues rather than the patient's own tissue

Artificial ligaments and xenograft (animal material) remain options but are seldom considered.


Technical considerations

There are different technical procedures available to the surgeon, but the tendency is towards all-inside single-bundle reconstruction.


ACL reconstruction

Professor Adrian Wilson explains how thinking moved in a not-very-helpful way during the years that cruciate ligament reconstruction was being developed

An 'interpretation' of a 2010 paper on the old question of whether patients with cruciate ligament injury end up with osteoarthritis. The problem is that the goalposts keep moving as surgical techniques change and rehabilitation regimes change.

An 'interpretation' of a 2009 literature review trying to determine the real incidence of osteoarthritis after cruciate ligament injury.

An 'interpretation' of a 2009 paper looking at the factors that increase the likelihood of developing osteoarthritis after cruciate ligament injury.

Graft choice for cruciate ligament reconstruction

There are different options for cruciate ligament reconstruction, both in terms of the procedure and also the graft material.

The fundamental reason for surgical treatment of ACL rupture is to stop symptomatic instability which can produce recurrent injury - especially meniscal tears....




Anterior cruciate ligament reconstruction: principles of treatment. Paschos NK and Howell SM. EFORT Open Rev. 2016 Nov; 1(11): 398–408.

Management of Anterior Cruciate Ligament Injury: What's In and What's Out? Raines BT, Naclerio E and Sherman SL. Indian J Orthop. 2017 Sep-Oct; 51(5): 563–575.

A Review on Biomechanics of Anterior Cruciate Ligament and Materials for Reconstruction. Marieswaran M, Jain I, Garg B, Sharma V and Kalyanasundaram D. Appl Bionics Biomech. 2018; 2018: 4657824.

Should return to sport be delayed until two years after anterior cruciate ligament reconstruction? Biological and functional considerations Nagelli CV and Hewett TE. Sports Med. 2017 Feb; 47(2): 221–232.

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