Private anterior cruciate ligament (ACL) reconstruction surgery

The anterior cruciate ligament (ACL) is a major ligament in the knee. This procedure is to repair the ACL if it becomes damaged or torn, and restore stability in your knee.

Sudden stops or changes in direction, for example during sports or vigorous exercise, can sometimes lead to a tear in the anterior cruciate ligament (ACL). We can deliver an ACL reconstruction surgery that repairs the torn ligament and restores stability in your knee.

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At HCA UK, we offer:

  • Appointments confirmed within 24 hours of you getting in touch
  • Access to some of the leading ACL reconstruction surgeons
  • Orthopaedic care rated very good or excellent by 97% of patients
Consultation with male patient

Why would I need ACL reconstruction surgery?

If you have an injury that's left your knee unstable and giving way, a full or partial ACL reconstruction may help improve the use of the joint. Left untreated, ACL damage can lead to long-term injury and further degeneration of the knee.

There are various reasons you might consider ACL reconstruction as an option, including:

  • If you have a very active lifestyle or play a lot of sports – either as a hobby or professionally
  • If you have a job that requires a lot of physical or manual activity
  • If you have damage to other areas of your knee and the joint is unstable.

Generally, if you’re an active person who relies on consistent use of your knees in your day-to-day life, ACL reconstruction can help you get back your full range of movement and prevent long-term damage.

How does ACL reconstruction surgery work?

Reconstruction of the ACL is usually done via arthroscopy, otherwise known as keyhole surgery. Your surgeon will make minor incisions in your knee and insert a small surgical camera (an arthroscope) to examine the inside of the joint. Other incisions will be made to allow access for surgical instruments. The procedure typically lasts between one and three hours, depending on whether further damage is discovered. It's usually performed under general anaesthetic.

How to prepare for ACL surgery

Before having the surgery, you may need to wait for any swelling to go down and to regain movement in your knee. This will make recovering from surgery easier. 

If your knee is still sore and stiff, preoperative physiotherapy will be required to prepare your knee for your operation. As part of our ongoing commitment to the gold standard requirement for pre-operative physiotherapy, your consultant may also advise you to wait until the muscles at the front and back of your thigh are as strong as possible.

Your consultant will explain the procedure to you fully, going over any potential risks and side effects. Your options for anaesthetic will also be discussed. Most people will have an ACL reconstruction under general anaesthetic (fully asleep). However, it can also be performed under regional anaesthetic, known as an epidural, where the lower part of your body is made numb.

If you are having general anaesthetic, you will be told to avoid eating or drinking for a period before your surgery. You’ll be asked for details of any medicines you regularly take to help inform your treatment plan. If you’re a smoker, you will be asked to refrain from smoking before and after the surgery to aid recovery.

What happens before an ACL reconstruction?

You will need to bring in any medication you take regularly and arrange your transport home for later that day. Many people come to hospital with a friend or family member who can also take them home afterwards.

When you arrive at one of our hospitals for ACL surgery, you will be shown to a private room by our nursing staff. They will also perform pre-operative checks such as taking your temperature and blood pressure.

Your surgeon and anaesthetist will visit you ahead of the operation to explain things once again and give you an opportunity to ask any questions. When it is time for your operation, you will change into a surgical gown and be taken to theatre where an anaesthetist will begin administering your anaesthetic.

What happens during ACL reconstruction surgery?

Small incisions, known as portals, will be made in your skin to allow the surgical camera and tools to access your knee joint. A clear and sterile fluid will be pumped into the joint to expand it and make it easier for the surgeon to see on their monitor and manoeuvre around your knee.

Once set up, your surgeon will examine the entirety of your knee to confirm your initial diagnosis and check for any further damage that may need repairing. They may also take photographs of your knee joint to help inform your aftercare needs or future procedures.

Tissues from the patellar tendon or hamstring tendons are often used to repair the damaged ACL in reconstruction surgery. These are typically harvested and prepared at the time of surgery. In some cases, donated tissue called allograft is used instead. Synthetic grafts may also be used when multiple ligaments are affected or in cases of revision surgery. Small tunnels are very precisely drilled into your leg bones where the new ACL needs to pass. The chosen graft will be secured into the site where your old ACL was with screws, buttons or staples. These will remain in place permanently.

After the reconstruction has been completed, your surgeon will test the strength of the graft and examine how it performs through your knee's full range of motion. They will then remove the tools and fluid from your knee and close the portals using stitches or steri-strips.

What happens after ACL reconstruction surgery?

You’ll be taken to a recovery area and then your private room as the effects of your anaesthetic wear off. Our nursing staff will be there to offer anything you need including pain relief. Once you’ve fully come around, you will be offered something to eat and drink.

It's unlikely that you'll stay in hospital overnight following an ACL reconstruction, but you'll need someone to drive you home and may require additional help in the early stages of your recovery. You will be provided with crutches to help you get around immediately after your operation. People typically use them for a few weeks after undergoing ACL reconstruction to avoid putting weight through the affected knee.

Our staff will explain any medication that you need to bring home with you, as well as advise on some physiotherapy exercises you can do at home to help the recovery process. We might also schedule some appointments with you to check-up on your recovery.

Once we have performed all necessary observations and you’re comfortable getting around, you will be free to go.

Benefits of ACL reconstruction surgery

ACL reconstruction surgery has many benefits to consider. It can:

  • Relieve pain
  • Help stabilise your damaged knee, reducing the risk of further injury
  • Allow you to return to your usual level of physical activity or sports

ACL reconstruction should return your knee to full, or almost full, mobility. It has a very high long-term success rate, reducing the likelihood of future complications.

Potential risks of ACL reconstruction surgery

  • Complications during surgery: infection, bleeding, adverse reaction to anaesthetic
  • Issues with your graft, such as misplacement, incorrect tension or incorrect fixing, could result in continued instability or create issues in other areas like your knee cap
  • An increased risk of re-injury during the recovery phase. Studies show this is especially true if returning to activities such as sport within two years of your initial injury.

ACL reconstruction FAQs

There are three grades of ACL injury:

Grade 1: A sprain of the ligament that may be painful and uncomfortable over a short period. With rest and anti-inflammatory medication, this type of injury should heal in a few weeks

Grade 2: A partial tear of the ligament, where some of it remains intact. These types of injury are much rarer than either grade 1 or 3. Physical therapy can help to strengthen the area around a partially torn ACL, with recovery achievable in three months for most.

Grade 3: A completely torn ligament. This is a significant injury, especially for people in careers such as professional sports. Athletes will certainly require surgery to return to full fitness. But those who are not aiming to return to sports or strenuous activities may be able to live without surgery, even after a grade 3 tear but it can increase the chances of developing complications later in life.

First, your consultant will offer you a thorough assessment. This will include questions, a physical examination and an MRI scan. Following this, they'll be able to discuss your options, including non-surgical treatment as well as a surgical reconstruction.

If you wish to consider surgery, your consultant will discuss the following with you:

  • The type of graft tissue to be used (your own, a donor's or synthetic)
  • The potential risks of surgery, including the risk of failure
  • The planned benefits of your ACL reconstruction surgery
  • Your rehabilitation programme
  • Success rates and timing of return to sport

If you do not elect to have ACL reconstruction surgery, any combination of the following may be recommended to manage your condition:

RICE: Rest, ice, compression and elevation will help reduce how much your knee swells after your injury

Pain relief: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are also useful in limiting swelling as well as helping you keep on top of any pain or discomfort

Supportive equipment: Wearing a knee brace will provide compression to manage inflammation and also support the joint as you bear weight to prevent the knee buckling

Change your activity: If you regularly play sports such as football, rugby or dance, you may need to take it easy for many months while recovering. Avoiding strenuous activity is likely to be recommended for people that have suffered any grade of ACL injury for varying periods of time.

While ACL reconstruction is very common, it’s considered major surgery. The procedure is invasive and typically carried out under general anaesthetic. Recovery times for this type of surgery can be long and, despite the very high success rate, the surgery comes with the risk of complications, just as any other surgery would.
If a complete ACL tear is left untreated, it can develop into a chronic ACL deficiency. This can lead to serious consequences in the future, such as increasing weakness in the joint. This can result in the knee routinely giving way and long-standing pain.  Those with grade one or two ACL tears may be able to manage fine without surgery. 
If you suffer a lower-grade injury to your ACL, it may be able to heal without surgery. However, in most cases, there won’t be any blood supply to the damaged ligament, meaning your ACL won’t be able to heal on its own.

During the surgery itself, you’ll typically be under general anaesthetic (as advised by your consultant) so won't experience any pain. This will also ensure that the muscles surrounding the joint are relaxed enough to conduct the procedure.

Towards the end of the operation, a local anaesthetic may be administered around the knee to help limit the pain. As with all surgical procedures, there may be some pain following the procedure. However, this can be managed with most standard pain-relief medication.

A full recovery from ACL reconstruction surgery can take anywhere from six months to a year.

In the first few days after surgery, you’ll get an ACL reconstruction physiotherapy plan to follow from one of our specialists. This fully personalised programme will consist of exercises that have been tailored to you and your recovery. They will be based on the extent of the damage your knee has suffered and the level of physical activity you’re looking to return to.

Two weeks after surgery, most patients can get around on crutches. After six months, most can return to playing sports. However, it’s important to remember that recovery rates vary from person to person.

This will depend on your individual circumstances, but most people are typically able to drive within a month of having an ACL reconstruction. Once you feel comfortable regularly putting weight on the affected leg, there's a good chance that you'll be able to drive.

Depending on your job, this could be a matter of weeks or months. People who do jobs that involve a lot of physical labour or walking may have to wait much longer than those who do sedentary work in an office.

Professional athletes will require a much longer period out of action because the rehabilitation period to return to full strength is increased. ACL injuries typically keep professional athletes out of action for up to a year. 

Why choose HCA UK

Why choose HCA UK for ACL reconstruction surgery?

Appointments to fit your schedule: We'll aim confirm your appointment within 24 hours of your referral. You can book an appointment with a consultant and get any required diagnostic tests on the same day for added convenience

Leading diagnostic technology: Our centres are equipped with the very latest in imaging equipment and all your scans will be assessed by a musculoskeletal radiologist

Top ACL reconstruction surgeons: Your care will be led by a British Orthopaedic Association (BOA) with a demonstrable track record in ACL reconstruction treatment

Top-ranking care: We're ranked as the leading provider of private orthopaedic care in London by the Private Healthcare Information Network (PHIN)

Meeting official standards: Our consultants follow the strict standards of the British Orthopaedic Association (BOA)

Patient satisfaction: Our 2022 patient survey revealed that 96% of our orthopaedic patients who would recommend us to friends and family.

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How much does private ACL reconstruction surgery cost?

We offer this treatment at a fixed price at some of our facilities.

How to book an appointment

Book an appointment with an ACL reconstruction specialist

We're happy to help you make an appointment with one of our experienced knee consultants. We can also make imaging and outpatient physiotherapy appointments for you.

Private anterior cruciate ligament (ACL) reconstruction surgery Consultants

Mr Mazin Ibrahim

Mr Mazin Ibrahim

Orthopaedic Surgery

Mr Ricci Plastow

Mr Ricci Plastow

Orthopaedic Surgery

Mr Luke Jones

Mr Luke Jones

Orthopaedic Surgery

Mr Rahul Patel

Mr Rahul Patel

Orthopaedic Surgery

Our Private anterior cruciate ligament (ACL) reconstruction surgery locations

Institute of Sport Exercise and Health (ISEH)

Institute of Sport Exercise and Health (ISEH)

170 Tottenham Court Road W1T 7HA London
The Princess Grace Hospital

The Princess Grace Hospital

42-52 Nottingham Place W1U 5NY London
The Lister Hospital

The Lister Hospital

Chelsea Bridge Road, SW1W 8RH London
The Shard Outpatients

The Shard Outpatients

The Shard, 32 St Thomas Street SE1 9BS London
London Bridge Hospital

London Bridge Hospital

27 Tooley Street SE1 2PR London
The Wellington Hospital

The Wellington Hospital

8A Wellington Place NW8 9LE London

This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.