Knee
ACL Reconstruction
The anterior cruciate ligament stops the shin bone sliding forward and keeps the knee stable when you pivot. Once torn it does not heal back, so reconstruction replaces it with a graft, usually tendon taken from your own leg, threaded through tunnels in the bone and fixed in place.
By appointment only, at Kharar (Mohali) or Solan. Your confirmation says which.
How the injury usually happens
The classic ACL tear is non-contact: planting a foot and turning, landing awkwardly from a jump, or a sudden change of direction. Football and cricket account for a large share of them here. Many people describe hearing or feeling a pop, followed by the knee swelling within a few hours.
After the initial swelling settles, the knee often feels deceptively normal walking in a straight line. The problem shows up on turning, when it gives way. Each of those episodes can damage the meniscus and the joint surface, which is the main argument for not simply living with it if you are young or active.
Do you always need surgery?
No. A torn ACL in someone whose work and hobbies are straight-line (walking, cycling, treadmill, swimming) can often be managed with a structured strengthening programme and no operation at all.
Reconstruction is usually advised when:
- The knee gives way during ordinary activity, not just sport
- You want to return to a pivoting sport
- There is a meniscus tear that needs repairing at the same time
- Other ligaments were injured alongside the ACL
- Your job demands stability on uneven ground
What the operation involves
It is done arthroscopically, through small keyhole incisions with a camera, and typically takes an hour to ninety minutes. The graft is taken, usually from the hamstring tendons, tunnels are drilled through the shin and thigh bone at the ligament's natural attachment points, and the graft is pulled through and fixed at both ends.
Most ACL surgery is done as a day case or with one overnight stay. If the meniscus is torn it is repaired or trimmed in the same sitting, which is one reason not to leave an unstable knee for years.
Dr. Khanna trained in knee and shoulder arthroscopy at Golden Clinics & Hospital, Chandigarh, and has research submitted on patient-reported outcomes after hybrid tibial fixation in soft-tissue grafted ACL reconstructions.
Recovery and getting back to sport
The operation is the short part. The rehabilitation is the treatment, and rushing it is the single most common reason a reconstruction fails.
- Week 0 to 2. Swelling control, getting the knee fully straight, and switching the quadriceps back on. Crutches for a short period.
- Week 2 to 6. Full range of movement, walking normally, static cycling.
- Week 6 to 12. Progressive strengthening, balance and control work.
- Month 3 to 6. Running in a straight line, then agility and gradual pivoting work.
- Month 9 to 12. Return to competitive pivoting sport, once strength and hop testing show the operated leg has caught up with the other one.
Returning at six months because the knee feels fine is how people re-tear grafts. The graft goes through a biological weak phase in the middle of that timeline, which is exactly when the knee starts feeling normal.
Risks worth knowing about
Re-tearing the graft, particularly on early return to sport, is the main one. Others include stiffness or loss of full extension, kneeling discomfort at the graft site, infection, blood clots, and residual instability. Numbness in a patch of skin below the incision is common and usually settles.
Common questions
How soon after the injury should surgery be done?
Usually not immediately. Operating on a hot, swollen, stiff knee raises the risk of stiffness afterwards, so a few weeks of physiotherapy to settle it down and restore movement first generally gives a better result. A locked knee from a displaced meniscus tear is the exception and is dealt with sooner.
Which graft is used?
Most often the hamstring tendons from the same leg. The choice depends on your sport, your build, whether this is a first or revision reconstruction, and what else is injured, and it is discussed before the operation.
Will I be able to play football again?
Most people who complete the rehabilitation return to their previous sport. That said, the completion is the condition, not the calendar date. Return is decided on strength and control testing rather than time alone.
Is a brace needed afterwards?
Sometimes early on, particularly if the meniscus was repaired at the same time. It is not universal and depends on what was done inside the knee.
Not sure whether you need this?
That is the right question to bring to a consultation. Second opinions on surgery already advised elsewhere are a routine part of the practice. Bring your imaging and any plan you have been given.
Not sure this is your problem?
These start from the symptom rather than the operation, and cover what else can cause it and what gets tried first.