ACL Reconstruction Surgery
at Aster MIMS Kannur
Your ACL helps stabilise the knee during pivoting and changes of direction. A tear can cause giving way, although symptoms and activity needs differ. When reconstruction is appropriate, Dr. Vishnu uses a tendon graft and anatomical tunnel placement to improve stability, with rehabilitation planned around your sport and goals.
Medically reviewed by Dr. Vishnu Baburaj, MS Ortho (PGI Chandigarh), MRCS (UK) · Last updated July 2026
What is the ACL and how does it tear?
The anterior cruciate ligament (ACL) is one of the four major ligaments inside the knee joint. It runs diagonally through the centre of the knee and prevents the shin bone from sliding forward relative to the thigh bone. More importantly, it controls the rotational stability of the knee during pivoting, cutting, and sudden deceleration. An ACL tear can cause giving way during these movements. Repeated instability may put the meniscus at risk, but symptoms and activity demands vary between patients.
ACL tears most commonly occur during non-contact mechanisms: a sudden change of direction, an awkward landing from a jump, or a deceleration with the foot planted. You may hear or feel a popping sensation, followed by rapid swelling within the first few hours. The knee often feels unstable immediately, and weight-bearing becomes painful. An MRI confirms the diagnosis and reveals whether the meniscus or other structures have been damaged.
Reconstruction rather than direct repair is the standard of care because the torn ACL has a poor blood supply and does not heal reliably when sutured back together. Instead, a new ligament is built using a tendon graft harvested from your own body. The graft is positioned in the anatomical footprint of the original ACL and fixed securely inside bone tunnels, where it gradually incorporates and matures into a functioning ligament over 9 to 12 months.
Anatomical tunnel placement
Bone tunnels are drilled at the anatomical footprint of the original ACL, not in a generic position. Anatomical placement restores the natural rotational stability of the knee, which is critical for pivoting sports. This technique has been shown to produce superior functional outcomes compared to non-anatomical reconstruction.
Graft selection tailored to you
The choice of graft (hamstring, bone-patellar tendon-bone, or quadriceps tendon) depends on your sport, anatomy, activity demands, and personal preferences. Dr. Vishnu discusses the evidence behind each option so you can make an informed decision together.
Meniscus repair when possible
Meniscal tears found alongside ACL injuries are addressed during the same procedure. Whenever the tear pattern permits, the meniscus is repaired rather than removed. Preserving the meniscus protects the cartilage and significantly reduces the risk of early-onset arthritis.
Choosing the right graft
The graft is the tendon tissue used to build your new ACL. Each graft type has distinct advantages. The choice is a shared decision between surgeon and patient, based on your sport, anatomy, and recovery goals.
Hamstring
Lower harvest site pain
Smaller incision for graft harvest
Excellent for recreational athletes
Strong, multi-strand construct
Bone-Patellar Tendon-Bone
Bone-to-bone healing in tunnels
Gold standard for competitive athletes
Strongest published evidence base
Higher initial stiffness for early rehab
Quadriceps Tendon
Emerging preferred graft option
Lower anterior knee pain than BPTB
Strong, versatile graft for all sports
Ideal for revision ACL cases
Evidence note: Current evidence supports all three graft types for primary ACL reconstruction. The choice depends on patient-specific factors rather than graft superiority alone. Dr. Vishnu uses the graft that best matches your sport, anatomy, and rehabilitation capacity.
Who needs ACL reconstruction?
ACL reconstruction is recommended for patients with a confirmed ACL tear who have functional instability or wish to return to pivoting sports. The following scenarios are commonly treated at Aster MIMS Kannur.
Complete ACL Tear
Complete rupture confirmed on MRI in a patient with functional instability. The knee gives way during pivoting, cutting, or descending stairs, preventing return to normal activity.
ACL with Meniscus Damage
Combined ACL tear and meniscal injury. Reconstruction stabilises the knee and creates the conditions for meniscal repair to heal. Delay increases the risk of irreparable meniscal damage.
Recurrent Knee Instability
Repeated episodes of the knee giving way during daily activities or low-level sport, despite attempted physiotherapy and activity modification.
Competitive Athletes
Athletes in pivoting sports (football, kabaddi, badminton, basketball) who require a stable knee for cutting, jumping, and rapid direction changes. Reconstruction is the standard of care.
Young Active Patients
Patients with decades of activity ahead. Reconstruction protects the meniscus and cartilage from the cumulative damage caused by an unstable knee over many years.
Revision ACL
Failed previous ACL reconstruction with recurrent instability. Revision surgery addresses tunnel malposition, graft failure, or biological incorporation issues from the initial procedure.
From injury to return to sport
Assessment and planning
A thorough clinical examination of the knee, including Lachman test and pivot shift, confirms the diagnosis. MRI reveals the ACL tear and identifies any meniscal or cartilage damage. Dr. Vishnu discusses the graft options, expected timeline, and rehabilitation demands. Pre-operative physiotherapy may be recommended to optimise knee range of motion and quadriceps strength before surgery.
Arthroscopic surgery
Under spinal anaesthesia, the graft is harvested through a small incision and prepared on the back table. The knee is examined arthroscopically, the torn ACL remnant is debrided, and any meniscal tears are addressed. Bone tunnels are drilled at the anatomical ACL footprint on both the femur and tibia. The graft is passed through the tunnels and fixed securely. The procedure takes 60 to 90 minutes.
Early rehabilitation
Early rehabilitation focuses on controlling swelling, restoring knee extension and activating the quadriceps. Your team explains when to bear weight, how to use crutches and whether a brace is needed. Meniscus repair or other associated procedures may require extra protection. Discharge and physiotherapy are planned around your progress.
Return to sport
Running and sport-specific drills are introduced as strength, movement control and tolerance improve. Demanding pivoting sport often requires 9 to 12 months or longer. Clearance depends on clinical review, strength and functional testing, confidence and any associated injuries. A date alone cannot establish readiness or remove the risk of reinjury.
Why Aster MIMS Kannur?
Aster MIMS Kannur is an NABH-accredited multispecialty hospital with a full arthroscopy suite, in-house MRI, and a dedicated physiotherapy department. Surgical care is supported by rehabilitation, strength and movement assessment to guide a gradual return to activity.
Request an appointmentNABH Accredited
National Accreditation Board for Hospitals certification, verifying adherence to patient safety and quality standards across every department.
Full HD Arthroscopy Suite
High-definition arthroscopy system with specialised instruments for ACL reconstruction, meniscal repair, and cartilage procedures. Arthroscopy is used for suitable injuries; some conditions need an open procedure.
Structured Return-to-Sport Protocol
Evidence-based rehabilitation with objective milestones at each phase. Return to competitive sport is cleared by functional testing, not just calendar time.
Read the detailed guide to returning to the gym after ACL surgery.
Continuous Post-Operative Support
WhatsApp access to the surgical team throughout recovery. Video consultations for out-of-station patients. Rehabilitation guidance from surgery through return to sport.
What does ACL reconstruction cost?
Quoted individually
The total depends on the implant or fixation used, room category, any associated procedures, and length of stay. You receive a written estimate before any decision is made.
Insurance & cashless
Most major insurers cover surgery at Aster MIMS Kannur. Cashless admission and pre-authorisation assistance are available; the insurance desk confirms your policy coverage before admission.
Get a written estimate
Send your reports on WhatsApp and receive a personalised estimate, with no obligation.
Request EstimateWhat does recovery actually look like?
Walk through the ACL reconstruction timeline phase by phase, from surgery day to tested return to sport.
Travelling from outside India?
ACL reconstruction for a travelling patient needs a plan for imaging review, early physiotherapy, safe travel and staged rehabilitation after returning home. Start with a provisional review of your existing records before making travel arrangements.
From the published literature
Dr. Vishnu's published research on this topic
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Quadriceps tendon autograft is promising with lower graft rupture rates and better functional Lysholm scores than hamstring tendon autograft in pediatric ACL reconstruction
Dr. Vishnu's published comparison of quadriceps and hamstring grafts in young ACL patients, evidence that informs the graft choices discussed on this page.
30+ peer-reviewed publications · 450+ citations · H-index 13 · View all research
ACL reconstruction FAQ
How do I know if my ACL is torn?
A torn ACL typically presents with a popping sound or sensation at the time of injury, rapid swelling within the first few hours, and a feeling of the knee giving way or being unstable during pivoting or direction changes. An MRI scan confirms the diagnosis and also shows whether the meniscus or other ligaments have been damaged. Clinical examination by an experienced surgeon can often diagnose the tear before the MRI.
Does a torn ACL always need surgery?
Not always. The decision depends on your activity demands, the degree of instability, whether the meniscus is damaged, and your age. Patients who participate in pivoting sports or who experience recurrent instability episodes are strong candidates for reconstruction. Patients with low activity demands and a stable knee may manage with physiotherapy and activity modification alone.
Which graft is best for ACL reconstruction?
There is no single best graft. Hamstring autograft offers lower harvest site pain and is excellent for recreational athletes. Bone-patellar tendon-bone provides bone-to-bone healing and is the gold standard for high-demand competitive athletes. Quadriceps tendon is an emerging preferred graft offering strength and versatility with lower anterior knee pain than BPTB. Dr. Vishnu discusses the options and recommends the graft best suited to your sport, anatomy, and goals.
How long is recovery after ACL surgery?
Rehabilitation progresses from controlling swelling and regaining movement to strength, running and sport-specific training. Meniscus repair or other associated injuries can change the plan. Return to demanding pivoting sport often takes 9 to 12 months or longer and requires clinical review and functional testing. The calendar alone does not establish readiness.
Can the meniscus be repaired during ACL surgery?
Yes. A meniscus tear can be assessed and treated during ACL reconstruction. Preserving repairable tissue helps maintain the meniscus's load-distributing role. The decision depends on the tear pattern, tissue quality and other findings. A repair may change your weight-bearing and rehabilitation plan, and it does not eliminate the risk of future arthritis.
Will I be able to play sports again?
Returning to sport is an important goal, but returning to the same level is not assured. Readiness depends on graft healing, strength, movement control, confidence and the demands of your sport. Dr. Vishnu uses strength and functional testing alongside clinical review to guide a gradual return. Passing these checks reduces uncertainty but cannot eliminate the risk of another injury.
What happens if I delay ACL surgery?
Timing depends on your symptoms, activity goals and associated injuries. Repeated giving-way episodes can damage the meniscus or cartilage, so avoid activities that trigger instability and seek assessment. When surgery is appropriate, preparation may include reducing swelling and improving movement. The plan balances these needs rather than treating every ACL tear as an immediate operation.
Is ACL reconstruction done as keyhole surgery?
Yes, ACL reconstruction is performed entirely through arthroscopic (keyhole) techniques at Aster MIMS Kannur. The procedure uses 2 to 3 small incisions around the knee, each less than 1 cm. A high-definition camera inside the joint allows the surgeon to visualise the torn ligament, prepare the tunnels, and fix the graft under direct vision. The graft harvest requires a separate small incision over the donor tendon site.
ACL Recovery: Month-by-Month Guide
Understand the stages of graft protection, rehabilitation and assessment before returning to sport. Timings depend on your recovery.
Arthroscopic Knee Surgery at Aster MIMS
Meniscus repair, cartilage procedures, and diagnostic arthroscopy through minimally invasive keyhole techniques.