Last Updated on November 18, 2025 by Ugurkan Demir

At Liv Hospital, we offer top-notch healthcare for patients from around the world. Arthroscopic ACL reconstruction is the best way to fix ACL injuries. Jaden Ivey’s successful surgery shows how effective this method is.

Every year, over 200,000 people get this surgery. It’s faster and safer than old methods. We’ll show you how it’s done, step by step.

Key Takeaways

• Arthroscopic ACL reconstruction is a minimally invasive technique.
• Faster recovery and fewer complications compared to traditional methods.
• Liv Hospital provides world-class healthcare for international patients.
• Over 200,000 ACL reconstruction procedures are performed annually.
• Expert care with a focus on patient safety and recovery.

Understanding ACL Injuries and Their Significance

The anterior cruciate ligament (ACL) is key to knee stability. Injuries to it can greatly affect athletes. ACL injuries are common and can harm an athlete’s performance and career.

Common Mechanisms of ACL Injury

ACL injuries often happen during sports with sudden stops, changes in direction, or direct contact. The main causes include:

• Non-contact injuries, like landing awkwardly from a jump or sudden stops.
• Contact injuries, where a direct hit to the knee causes the injury.
• Pivoting or twisting movements that stress the ACL too much.

Clinical Evaluation and Diagnosis

Diagnosing an ACL injury involves clinical evaluation and imaging studies. The clinical evaluation includes:

1. A detailed medical history to understand the injury context.
2. A physical exam, like the Lachman and pivot shift tests, to check knee stability.
3. Imaging studies, such as MRI, to confirm the injury and check for other injuries.

Early and accurate diagnosis is key for proper management and injury prevention.

Impact on Athletic Performance

ACL injuries can greatly affect an athlete’s performance and career. Recovery can take 6 to 12 months of rehab before returning to full activity. There’s also a risk of re-injury and long-term issues like osteoarthritis.

Athletes like NBA player Jaden Ivey, who had ACL surgery, show the challenges of recovery. They highlight the need for effective rehab protocols.

Understanding ACL injuries and their effects on athletes is vital. By knowing the causes and the importance of early diagnosis, we can help athletes recover and return to sports.

Pre-operative Planning and Patient Selection

Arthroscopic ACL reconstruction needs careful planning for the best results. Good planning is key for a smooth surgery and quick recovery.

Patient Assessment and Medical Clearance

We start by checking the patient’s health and past treatments. This helps us see if there are any risks. Medical clearance makes sure the patient is ready for surgery.

We also look at the patient’s lifestyle and what they hope to get from the surgery. This helps us make a treatment plan that fits their needs.

Imaging Requirements and Analysis

Advanced imaging, like MRI, is vital for planning ACL reconstruction. We use these tools to see how bad the injury is and check the knee’s condition.

Our team carefully looks at the images to plan the best surgery. We decide on the graft, think about challenges, and if more procedures are needed.

“Pre-operative planning is a critical step in achieving successful outcomes in ACL reconstruction. It allows us to personalize the treatment plan and address possible complications ahead of time.” – Expert Orthopedic Surgeon

Discussing Expectations and Recovery Timeline

Teaching our patients is a big part of our planning. We explain the surgery, what to expect during recovery, and how long it will take. We also give them videos about ACL reconstruction.

By setting clear expectations and supporting them, we help our patients be active in their recovery. At Liv Hospital, we aim to provide top-notch care and prepare our patients well for surgery and rehab.

Equipment and Setup for Arthroscopic ACL Surgery

Arthroscopic ACL reconstruction needs skilled surgeons and the latest equipment. A well-organized operating room is also key. The right tools and setup are essential for a successful surgery.

Essential Instruments and Arthroscopic Equipment

For arthroscopic ACL reconstruction, specific tools are needed. These include:

• High-definition arthroscope with a camera system
• Light source and fiber-optic cable
• Shaver and burr system for debridement
• Radiofrequency ablation device
• Graft preparation instruments
• Tunnel creation and graft fixation devices

New arthroscopic equipment has greatly improved ACL reconstruction results. We use the latest technology to give our patients the best care.

Operating Room Configuration

The setup of the operating room is very important for ACL surgery success. Important factors include:

1. Positioning of the arthroscopic tower and monitors for optimal viewing
2. Placement of surgical instruments within easy reach
3. Proper lighting to minimize glare on monitors
4. Comfortable positioning of the surgical team

A well-set up operating room makes the surgery more efficient and precise.

Video Recording Setup for Documentation

Video recording is a must for arthroscopic ACL surgery. It helps document and review the procedure. Our setup includes:

• High-definition video recording system
• Secure storage for patient data and surgical videos
• Capability for slow-motion review and analysis

This documentation is useful for post-operative review, patient follow-up, and improving our techniques.

Anesthesia Considerations and Patient Preparation

Arthroscopic ACL reconstruction needs careful thought about anesthesia and patient prep. We know that the right anesthesia and prep are key for ACL surgery success.

Anesthesia Options and Selection

We offer many anesthesia choices for ACL arthroscopy, like general, regional, and local anesthesia with sedation. The right choice depends on the patient’s health, what they prefer, and the surgeon’s advice.

General anesthesia is often the top pick for a pain-free surgery. But, regional anesthesia, like femoral nerve blocks, can manage pain well with fewer side effects.

Tourniquet Application and Management

A tourniquet helps make the surgery area clear, making the procedure more precise. We use tourniquets carefully to avoid nerve damage or blood clots.

• The tourniquet is put on the thigh.
• Pressure is set based on the patient’s blood pressure.
• We keep an eye on tourniquet time to avoid too much ischemia.

Sterile Field Preparation and Draping

Keeping the surgical area clean is vital to avoid infections during ACL arthroscopy. We have a strict method for setting up the sterile field.

This includes using sterile drapes, antiseptic solutions, and careful technique. We make sure the area stays clean during the surgery.

Graft Selection and Harvesting Techniques

In arthroscopic ACL reconstruction, choosing the right graft is key. New graft selection methods have made treatments better and more tailored to each patient.

Autograft Options

Autografts come from the patient themselves. They are a top choice for ACL repairs. The main autografts are:

• Hamstring tendons
• Patellar tendon
• Quadriceps tendon

Each autograft has its own benefits. Doctors pick the best one based on the patient’s age, activity level, and body type. Hamstring tendons are often chosen for their low risk of complications. Patellar tendon grafts are strong but may cause more pain. Quadriceps tendon grafts are a good middle ground, being strong yet causing less pain.

Allograft Considerations

Allografts come from donors. They are an option for ACL repairs. The key factors in choosing an allograft are:

1. Tissue quality and sterility
2. Donor age and medical history
3. Graft size and compatibility

Allografts are good for those who don’t want to use their own tissue or have used it before. But, they might have a higher risk of infection and failure.

Graft Preparation and Sizing

After picking a graft, preparing and sizing it is vital. This means:

• Measuring carefully to fit the patient’s body
• Preparing the graft ends for fixing
• Checking the graft’s strength and quality

Our surgeons are skilled in preparing and sizing grafts. They make sure each graft fits the patient perfectly, improving the surgery’s success.

Arthroscopic Evaluation of the Knee Joint

We do a detailed arthroscopic check to see how the ACL is doing and any other knee problems. This careful look is key to finding and fixing all knee issues. It makes sure our patients get the best care possible.

Portal Placement and Triangulation

Getting the right spot for the arthroscopic view is very important. We make special entry points to see and work on the knee well. Triangulation techniques help us move tools around the joint accurately.

Systematic Diagnostic Arthroscopy

We use a detailed plan to check the knee. We look at every part, like the sides and the middle area. This meticulous examination helps us find any other injuries or problems.

“Arthroscopy allows for a detailed evaluation of the knee joint, enabling surgeons to identify and address associated injuries that may not be apparent through other diagnostic means.”

Identifying and Addressing Concomitant Pathology

While checking the knee, we often find other problems like torn meniscus or damaged cartilage. Fixing these issues at the same time as ACL surgery is important for the best results. We make a treatment plan that fits each patient’s needs.

• Meniscus repair or debridement
• Chondroplasty or cartilage restoration
• Removal of loose bodies or debris

Performing Arthroscopic ACL Reconstruction: Core Technique

To get good results in arthroscopic ACL reconstruction, surgeons need to know the core technique well. This technique includes several steps. These steps make sure the reconstruction is correct and works well.

ACL Remnant Debridement and Notch Preparation

The first step is to clean up the ACL remnant and get the notch ready. Debridement means removing the damaged ACL tissue. This lets us see where the ACL should be. We use special tools to remove the damaged tissue carefully.

Getting the notch ready is also key. We remove any extra bone or tissue that could get in the way. This makes it easier for the graft to heal.

Anatomic Femoral Tunnel Creation

Creating a tunnel in the femur that matches the ACL’s natural path is very important. This helps the graft heal better and work better.

We find the right spots and use a guide to drill the tunnel. We focus on the tunnel’s direction and depth. This ensures the graft is placed correctly.

Precise Tibial Tunnel Drilling

Drilling the tunnel in the tibia needs to be done carefully. We use a guide to place the tunnel right in the ACL’s footprint on the tibia.

The tunnel is made the right size for the graft. We make sure not to hurt the bone or soft tissues around it.

Graft Passage and Secure Fixation Methods

After the tunnels are ready, we pass the graft through them. We make sure it’s in the right place in the ACL’s footprint.

We use different devices to fix the graft in place. These include screws, suspensory devices, or a mix of them. The choice depends on the graft and the surgeon’s preference.

“The key to successful ACL reconstruction lies in the precise execution of each step, from debridement to graft fixation.” –

Expert Orthopedic Surgeon

By mastering these steps and understanding the details of each, surgeons can get great results in arthroscopic ACL reconstruction. ACL reconstruction videos are very helpful. They help surgeons learn and improve their skills.

Advanced Techniques in ACL Arthroscopy

The field of ACL arthroscopy has seen big changes. New techniques are giving patients better results. Several advanced methods stand out as very promising.

All-Inside Reconstruction Approach

The all-inside reconstruction technique is becoming more popular. It’s known for less pain and quicker recovery. This method uses small incisions and special tools to place the graft, causing less damage to tissues.

• Reduced soft tissue dissection
• Smaller incisions
• Potential for faster rehabilitation

Research shows the all-inside technique can match or even beat traditional methods. But, it needs precise skill and knowledge of special tools.

Double-Bundle Reconstruction Considerations

Double-bundle ACL reconstruction tries to mimic the ACL’s natural structure. It aims to improve rotational stability and knee function.

“Double-bundle ACL reconstruction has been shown to provide better rotational stability than single-bundle techniques in some studies.”

But, this method is more complex. It requires careful thought about graft size and tunnel placement. Surgeons must consider the benefits and the technical challenges and risks.

Anatomic Single-Bundle Techniques

Anatomic single-bundle ACL reconstruction aims to restore the ACL’s natural position with one graft. This method focuses on accurate tunnel placement and graft orientation for better knee movement.

Recent studies suggest anatomic single-bundle reconstruction can lead to great results. Success depends on careful planning before surgery and precise execution during it.

In conclusion, advanced ACL arthroscopy techniques like all-inside, double-bundle, and anatomic single-bundle offer hope for better patient outcomes. As we improve these methods, staying updated with the latest research is key to delivering top-notch care.

Managing Intraoperative Complications

During arthroscopic ACL reconstruction, surgeons face many challenges. They must be ready to handle these issues to ensure the procedure’s success.

Tunnel Malposition: Recognition and Correction

Tunnel malposition is a big problem. It can cause graft failure and bad results. We use detailed anatomical landmarks and imaging to place tunnels correctly.

To fix tunnel malposition, we check the tunnel’s position with arthroscopy and imaging. If needed, we make a new tunnel or adjust the old one for the best graft placement.

Graft Preparation and Passage Complications

Graft preparation and passage are key in ACL reconstruction. Problems can happen if the graft is not the right size or gets damaged during passage.

To avoid these issues, we use special tools and methods for graft preparation and passage. We also check the graft carefully before fixing it to make sure it’s good.

Fixation Challenges and Solutions

Fixation problems can occur for many reasons. These include bad fixation technique or poor graft quality. We use reliable fixation methods, like interference screws or suspensory fixation, for secure graft placement.

To solve fixation issues, we carefully look at the graft and the fixation area. We adjust our method as needed to get the best fixation.

By being ready to tackle intraoperative complications, we can give our patients the best results from arthroscopic ACL reconstruction.

Post-operative Protocol and Rehabilitation Progression

ACL reconstruction is just the beginning. A detailed post-operative protocol and rehabilitation plan are key to getting your knee back to normal. A good plan helps patients recover well, leading to the best results.

Immediate Post-operative Care and Pain Management

Right after surgery, we focus on managing pain, reducing swelling, and protecting the knee. We use a mix of medicines and cold therapy to help with pain. Patients are also encouraged to do gentle exercises to keep the knee moving and prevent stiffness.

Using a knee brace and crutches is often advised to support the knee and help with walking. We teach patients to watch for signs of complications like infection or blood clots. This way, they can get help quickly if needed.

Structured Rehabilitation Phases

The rehab process after ACL surgery is broken into phases, each with its own goals. The first phase aims to reduce pain, improve movement, and strengthen muscles around the knee.

Objective Criteria for Return to Activity

Deciding when to start activities again after ACL surgery is based on clear criteria. We check if the knee is strong, stable, and functional. This includes tests like isokinetic strength tests and hop tests.

Patients are allowed to start sports or hard activities when they meet certain standards. These include full range of motion, adequate strength (usually >90% of the other leg), and good functional testing. This careful approach helps ensure patients can safely go back to their activities without getting hurt again.

Conclusion

Arthroscopic ACL reconstruction is a top choice for treating ACL injuries. It offers a solid way for patients to get better. Our team has seen great results when we use this method with detailed guides and rehab plans.

Research shows that using autografts in ACL reconstruction boosts recovery. Patients see big improvements in how they move and feel, thanks to the Lysholm scores and IKDC. 

At Liv Hospital, we aim to give our international patients the best care. We use the newest in arthroscopic ACL reconstruction and video tech. This way, we make sure our patients get top-notch treatment.

REFERENCE 

• • Chahla, J., Moatshe, G., Cinque, M. E., Dornan, G. J., LaPrade, R. F., & Engebretsen, L. (2019). ACL Technique. Retrieved from https://www.jorgechahlamd.com/wp-content/uploads/2019/12/ACL-Technique.pdf

• Moatshe, G., LaPrade, R. F., Engebretsen, L., & Chahla, J. (2023). Arthroscopic Reconstruction of Anterior Cruciate Ligament Using Hamstring Autograft: Surgical Technique. Journal of Arthroscopic Surgery, 39(10), 2001–2010. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10532376/