When the anterior cruciate ligament (ACL) ruptures, surgery is often the recommended pathway, for active patients who want to return to sport or those whose knee remains unstable.
At Melbourne Knee Centre, that means matching every detail of your surgery to your knee, your sport and your reinjury risk, rather than applying a standard operation to every patient.
ACL reconstruction (rather than ACL repair) has been the standard surgical treatment for ACL rupture for several decades, and it remains the most commonly recommended option for the majority of patients.
ACL reconstruction replaces the damaged ligament with a tendon graft. The procedure is performed arthroscopically using small incisions and is designed to restore the ACL’s function and stability. It is particularly well suited to active patients, younger patients, and those who play sports involving pivoting, cutting and change of direction.
Recovery from ACL reconstruction is a significant commitment. The graft needs time to integrate into the knee. A structured rehabilitation program is essential to regain strength, control and confidence in the joint.
A return to pivoting sports typically takes many months. The right time is based on your achievement of functional goals rather than time alone.
We rely almost exclusively on your body’s own tissue (an autograft) to reconstruct your ACL, selecting a specific tendon that best suits your anatomy and long-term functional needs. Donor tissue (an allograft) may be used on rare occasions.
Options include:
Some patients face a higher risk of re-injuring a reconstructed ACL, including athletes in high-pivot sports such as netball, soccer and football, younger patients, and those with naturally hypermobile joints
If that’s you, we may recommend adding a lateral extra-articular tenodesis (LET) alongside your ACL reconstruction. This reinforces the outer side of the knee with an additional strip of tissue to help control rotation and protect the graft.
An ACL rupture rarely occurs in isolation. Often, your MRI or arthroscopy shows other concerns, such as a meniscal tear, cartilage damage, or an MCL or PCL injury.
If other injuries are present, we usually recommend restoring the entire joint ecosystem simultaneously in the same procedure, rather than in subsequent operations.
A well performed surgery lays the foundation for a successful recovery. Next, comes the hard work of rebuilding a knee you can trust.
We aim for a seamless transition into a structured, milestone-driven rehabilitation program, working closely with your primary physiotherapist to guide you through progressive stages of recovery.
Early rehabilitation focuses on settling swelling and restoring control of the quadriceps, before progressing through strength work to running, agility and pivoting drills as the graft matures.
A return to pivoting sports typically takes many months. Rather than setting a fixed date, we judge the right time based on your achievement of functional milestones so that you return to sport when your knee is ready for it. Having said that, a goal of returning to play after 12 months is a realistic goal for many of our patients.
At Melbourne Knee Centre, we perform a high volume of ACL surgeries, giving us substantial experience in these procedures.
Mr Nathan White’s training in elite sports medicine, including his Fellowship in Football Medicine with Chelsea Football Club, informs a considered, evidence-based approach to ACL reconstruction and repair. We take the time to explain the options clearly so you can make an informed choice.