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University of California San Francisco
Patient Education

ACL Reconstruction Surgery

Before surgery

When you check into the hospital or clinic, you will be directed to a waiting area where your paperwork will be completed and your knee may be shaved. You will be asked to wear a hospital gown and to remove all jewelry.

An anesthesiologist will discuss your mode of anesthesia. Then, you will be taken to the operating room.

The procedure

General or regional anesthesia typically is used for surgery. The anesthesiologist will administer the anesthesia to put you to sleep in the operating room.

The procedure usually takes less than two hours. It will require an incision to remove a tendon if you are undergoing an autograft, in which a tendon from another part of your body is inserted in your knee. Several small punctures are made for an arthroscope – a thin, flexible scope that allows the surgeon to see in your knee – and surgical instruments. With an allograft, in which tendons come from a cadaver, the surgery is shorter because the tendon is not removed from you.

The graft is passed through bone tunnels and fixed to the upper leg bone, or femur, and lower leg bone, or tibia, with screws or posts and stitches. The use of screws or posts is usually a surgeon's preference.

After the incisions are sewn up, a sterile dressing is applied. After the surgery, you'll be taken to the recovery room.

Recovery room

Following ACL reconstruction surgery, you'll be in the recovery room for at least two hours while the anesthetic wears off. Your knee will be bandaged and may have an ice pack for pain.

Ask for pain medication when you feel pain coming on. Pain medication works best when pain is developing rather than when pain becomes intense. You'll receive pain medicine, either orally or intraveneously. A nurse will give you the amount of medication that your doctor has prescribed and considers to be safe.

Move your feet while in the recovery room to improve circulation. Your surgeon may suggest that you use crutches or a cane for a period ranging from two days to three weeks. Most patients are able to walk carefully without crutches within two weeks.

When you're fully awake, you may be allowed to go home. Your nurse and doctor will determine when you are ready to leave the hospital or if an overnight stay is necessary.

Before you leave, you'll be given a follow-up appointment, if you don't already have one, and a prescription for pain medicine. You will be groggy and unable to drive a car, so arrange a ride home prior to surgery.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.

Related clinics

Sports Medicine Center

See our four locations and learn more about the clinic.

Recommended reading

A Woman's Aching Knees

Why are women winding up with more knee injuries? Researchers suspect one of the most likely causes is the way women are built. Learn more here.

After ACL Surgery

Your rehabilitation program to restore range of motion to your knee begins the moment you wake up in the recovery room after ACL surgery. Learn more here.

FAQ: Anterior Cruciate Ligament Surgery

Frequently asked questions regarding Anterior Cruciate Ligament (ACL) Surgery including how long you will be on crutches, beginning physical therapy and more.

Preparing for ACL Surgery

The decisions you make and the actions you take before your surgery can be every bit as important as the procedure itself in ensuring a healthy recovery.

Take Care of Your Knees

Although collateral ligament injuries can be difficult to avoid, here are several steps you can take to improve the strength and flexibility of your knees.

Conditions we treat

  • ACL injury

  • LCL tear

  • MCL tear

  • Patellofemoral pain syndrome

  • PCL tear

Did you know?

UCSF designed its new state-of-the-art Precision Cancer Medicine Building to support patients through every step of their cancer journey. The building houses a centralized check-in, dedicated acute care clinic, support center and comfortable spaces for pop-up services, such as nutrition classes and art therapy.

Learn more
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