ACL Reconstruction

• The anterior cruciate ligament, once torn, can never be repaired to its original state, but rather, reconstructed using other pieces of the body. There are three common ways by which surgeons go about reconstructing the knee.
  
  Using the central third of the patella tendon, which connects the knee cap to the shin bone, doctors will assembled a new ACL. When they pull the patella tendon from its initial place, surgeons also remove a piece of the bone to the patella and tibia, thereby not disturbing with the tendon attachments. This procedure, by which the patella tendon is placed into the knee as an ACL, is considered by many doctors to be the most secure type of ligament "graft." However, this procedure can yield pain and achiness in the knee for years to come.
  
  Since the hamstring tendon in the back of the thigh is equipped with plenty of tendons, this is often a popular form of ACL replacement. What surgeons do is remove a portion of the hamstring and use it to serve as the new ACL. This lessens the potential for pain in the future, however, some surgeons question its long-term stability as a full-time ACL replacement.
  
  A third popular form of ACL replacement is through donor tissue grafts, whereby the patella tendon of a cadaver is used to reconstruct a new ACL. However, this form of ACL reconstruction yields slower recovery time for the new ACL, and therefore less reliable. This procedure also carries the risk of infection or rejection, but an advantage is the procedure can usually be done arthroscopically, with far-less pain post-surgery.
  
  

Arthroscopic Surgery

• Arthroscopic surgery involves an instrument attached to a small camera. This camera, attached to the end of an arthroscope, send images to a screen, which allows the surgeon to view the inside of the knee via a less invasive route. This procedure is often done as an outpatient surgery, though some doctors will require an overnight stay.
  
  Before reconstructing the ACL, surgeons use arthroscopes to survey the entire knee joint, thus enabling them to survey any further damage, which may alter or postpone the surgery.
  
  

No Surgery

• In certain cases, people can repair the ACL without the need for surgery, typically through physical rehabilitation and a restrengthening of the knee. However, for those who want to resume any sort of stringent, athletic regimen, most doctors will recommend a full reconstruction of the knee, or arthroscopic surgery.