What Is ACL Reconstruction Surgery?
ACL reconstruction surgery swaps out a torn anterior cruciate ligament for a graft, restoring the rotational stability the knee needs for pivoting, cutting, and change-of-direction movement. An ACL injury ranges from a mild sprain to a complete rupture, and the extent of the tear largely determines which treatment path fits.
Because the ACL has a limited blood supply, it generally can’t be repaired by stitching the torn ends back together. Depending on the tear pattern, activity level, and whether other knee structures are involved, ACL reconstruction in Singapore may use the patient’s own tissue or reconstruction using donor tissue.
ACL Reconstruction Treatment Options
A torn ACL doesn’t automatically mean surgery. The right path depends on how the knee is actually behaving, not just what the scan shows, and this is where decisions about ACL treatment in Singapore get made.
Non-surgical management
One route within ACL tear treatment, may be considered for partial tears where the knee stays functionally stable, for lower-demand patients, or for those willing to modify activity rather than return to pivoting sport. Bracing and a structured physiotherapy programme built around strength and proprioception sit at the heart of this approach.
Reconstruction
Tends to be favoured for complete tears in active or younger patients, where instability persists despite physiotherapy, or where the injury pattern makes the knee unreliable for daily activity as well as sport. Surgery replaces the torn ligament with a graft, and a structured physiotherapy programme remains central to recovery after surgery.
On repair versus reconstruction: direct repair (stitching the original ligament) is rarely viable for the ACL because of its limited blood supply. This is different from ligaments elsewhere in the body that can sometimes be repaired directly. Reconstruction, replacing the ligament with a graft, remains the established approach where ACL reconstruction surgery is indicated.
None of this is a fixed formula. Two patients with the same tear grade can end up on different paths depending on age, sport, and how much instability they’re willing to live with day to day. That’s the judgement an orthopaedic assessment exists to make.
What Are the Surgical Approaches for ACL Reconstruction?
Arthroscopic Technique
ACL reconstruction is typically done arthroscopically, using a camera and small incisions to visualise and address the torn ligament. The surgeon can also check for meniscal or cartilage injuries in one procedure.
Autograft Reconstruction
An autograft uses the patient’s own tissue, often from hamstring or patellar tendon, to rebuild the ligament. It is considered for younger or more active patients for strong fixation and a lower risk of rejection.
Allograft Reconstruction
An allograft uses donor tissue rather than tissue taken from the patient’s own body. It may be considered for older patients, lower-demand patients, or cases where multiple ligaments require repair in one surgery.
Hybrid Graft Reconstruction
A hybrid graft combines autograft and donor tissue. This may be considered in complex or revision cases where a single graft source may not provide sufficient strength on its own, such as repeat or failed surgery.
What Happens Before, During and After Metatarsalgia Surgery
Before surgery
Surgeon will examine the knee for stability, swelling, range of motion, and associated injury. X-rays or an MRI may be recommended to assess the ligament, cartilage, and surrounding structures.
During surgery
Depending on your injury, the surgeon may:
- Remove the damaged ACL
- Prepare and position the selected graft
- Secure the graft using screws or other fixation devices
- Assess and address associated meniscus or cartilage injury
Anaesthesia
ACL reconstruction is usually carried out under general or regional anaesthesia. Your anaesthesia team will discuss the most suitable option with you beforehand.
After surgery
Your knee may be placed in a brace, and crutches are commonly used for a period afterwards. Your surgeon will explain pain and swelling management, wound care, and how to begin weight-bearing and physiotherapy safely.
Recovery After ACL Reconstruction Surgery
Recovery is a staged process that varies according to graft type, associated injuries, and individual healing.
Early recovery focuses on controlling swelling and regaining range of motion, with physiotherapy introduced progressively to rebuild strength and balance. Later stages shift toward functional and sport-specific training.
Return to sport is guided by functional recovery, not a fixed date, and should follow your surgeon’s and physiotherapist’s assessment of strength, stability, and confidence in the knee.
Don’t compensate around an unstable knee
Who May Be Suitable for ACL Reconstruction?
An orthopaedic assessment is needed to determine whether ACL tear surgery is appropriate for your case. The decision depends on tear severity, associated injuries, activity level, and response to non-surgical treatment.
ACL reconstruction may be considered for:
- People with a complete ACL tear and persistent knee joint instability
- Individuals wishing to return to pivoting, cutting, or jumping sports
- Patients with associated meniscus or cartilage injury within the knee
- Those whose knee goes on giving way despite physiotherapy and bracing
- Younger or highly active patients at greater risk of secondary injury
- Selected patients requiring revision surgery after previous treatment
About Your Orthopaedic Specialist
Dr Gowreeson Thevendran
MBChB (Bristol), MRCS.Ed, Dip. Sports Med.Ed, FRCS.Ed (Trauma & Orthopaedics), FAMS (Singapore)
Dr Gowreeson Thevendran is an ACL surgeon based in Singapore, specialising in lower limb orthopaedic conditions including knee ligament injuries, trauma, and fracture surgery. He completed sub-specialty fellowship training across three separate programmes, in foot and ankle surgery, sports surgery, and complex trauma and deformity correction, and received his medical education from the University of Bristol.
Before setting up his private practice, he served as Chief of Foot & Ankle Surgery in the Department of Orthopaedics at Tan Tock Seng Hospital, Singapore.
Questions patients ask
Frequently Asked Questions
When Should I See an ACL Specialist?
See an ACL specialist in Singapore promptly if your knee swells significantly after a twisting injury, feels unstable, or gives way when walking or changing direction. Early assessment helps determine the tear grade and check for associated injuries.
Do All ACL Tears Require Surgery?
Not always. Whether surgery is needed depends on tear severity, activity level, and how the knee responds to non-surgical care.
What Is the Difference Between ACL Repair and Reconstruction?
Repair, stitching the original ligament, is rarely viable for the ACL due to its limited blood supply. Reconstruction, replacing it with a graft, is the more established approach for a complete tear.
How Long Does Recovery Take After ACL Surgery?
Recovery is a staged process spanning several months, moving from swelling control and range of motion through progressive strengthening to a gradual, criteria-based return to sport. Timelines vary by individual and graft type.
Can I Return to Sports After ACL Reconstruction?
Many patients return to sport after ACL reconstruction. Timing depends on graft healing, strength, stability, and progress through rehabilitation, and should be confirmed by your surgeon and physiotherapist.
What Are the Symptoms of an ACL Tear?
A torn ACL often causes significant swelling after a twisting injury. The knee may feel unstable, especially during pivoting or twisting movements, and it may give way when you walk or change direction.
How Is an ACL Tear Diagnosed?
Diagnosis starts with an examination of the knee. The surgeon checks stability, swelling, range of motion and any associated injury. X-rays or an MRI may then be recommended to assess the ligament, cartilage and surrounding structures, and to check for meniscus or cartilage injury.
What Types of Graft Are Used in ACL Reconstruction?
There are three main options. An autograft uses your own tissue, often from the hamstring or patellar tendon. An allograft uses donor tissue. A hybrid graft combines both and may be considered in complex or revision cases.
Is Knee Instability Affecting Your Daily Life?
If your knee continues to give way or feels unstable, an orthopaedic assessment can help identify the cause and discuss your treatment options.