How long does ACL reconstruction surgery take?

The procedure usually lasts between 60–90 minutes, but total hospital time, including pre-operative and post-operative care, may be several hours.

When can I start walking without crutches?

The timing varies between individuals. Some patients may be able to stop using crutches within the first few weeks, depending on pain, swelling, knee control and whether other procedures were performed at the same time.

Will my knee be as strong as before after ACL reconstruction?

With proper rehabilitation, many patients regain knee strength comparable to pre-injury levels, although individual outcomes vary.

Can ACL reconstruction prevent future knee injuries?

While ACL reconstruction helps restore knee stability, ongoing strengthening, balance training and injury prevention exercises may help reduce the risk of future knee injuries.

Is ACL reconstruction always necessary for a torn ACL?

No. Some ACL injuries can be managed with physiotherapy, activity modification and other non-surgical measures. ACL reconstruction may be considered when there is persistent knee instability or when an individual wishes to return to activities that place high demands on the knee.

Are women more at risk of ACL injuries than men?

Female athletes have a higher rate of ACL injury than male athletes in some sports involving cutting, pivoting and jumping. The reasons are multifactorial and may involve anatomical, biomechanical and other factors. Neuromuscular and strengthening programmes may help reduce ACL injury risk.

Can I have ACL reconstruction if I also have a meniscus tear?

Yes, and in many cases, meniscal injuries are addressed during the same operation as the ACL reconstruction. Your surgeon will assess the meniscus during arthroscopy and, where appropriate, perform a meniscus repair or partial meniscectomy at the same time, which may avoid the need for a second procedure.

How do I know when I am ready to return to sport after ACL reconstruction?

Return to sport should be based on individual recovery rather than time alone. Your surgeon and physiotherapist may assess factors such as strength, range of motion, functional performance, knee stability and psychological readiness. Return to competitive or pivoting sports is often considered from around 9–12 months, although timing varies between individuals.

ACL Reconstruction Surgery in Singapore

The anterior cruciate ligament (ACL) is one of the most important stabilising structures in the knee and one of the most commonly injured, particularly among athletes and active individuals. Whether the injury occurs on the football pitch, basketball court or during a sudden change of direction in everyday life, a complete ACL tear can cause significant instability, pain and reduced confidence in the knee. When these symptoms affect daily activities or the ability to return to sport, ACL reconstruction may be recommended to restore knee stability and function.

What Is ACL Reconstruction?

ACL reconstruction is a surgical procedure used to treat an ACL injury by replacing the damaged ACL with a graft, usually sourced from the patient's own hamstring, patellar or quadriceps tendon, or from donor tissue. The goal is to restore knee function, improve stability and help individuals return to daily activities and sport.

Rather than repairing the torn ligament itself, ACL reconstruction creates a new ligament using a tendon graft. This is because the ACL has a limited blood supply and tissue characteristics that make direct repair less reliable in many cases. Over time, the graft undergoes a biological process known as ligamentisation, gradually developing properties similar to those of the original ACL.

Graft Type	Source	Key Advantages	Key Considerations
Hamstring Tendon Autograft	Hamstring tendon from the patient's own knee	Smaller incision, less front-of-knee pain and established long-term outcomes	Slightly longer healing time
Patellar Tendon Autograft	Patellar tendon from the patient's own knee	Strong initial fixation, often chosen for high-demand athletes	Higher risk of front-of-knee pain and kneeling discomfort
Quadriceps Tendon Autograft	Quadriceps tendon from the patient's own knee	Larger graft diameter, useful for some revision procedures	Larger incision with temporary thigh weakness or discomfort
Allograft	Donor tendon	No tendon harvest, shorter operation	Higher re-tear risk in younger, active patients

Graft Type

Source

Key Advantages

Key Considerations

Hamstring Tendon Autograft

Hamstring tendon from the patient's own knee

Smaller incision, less front-of-knee pain and established long-term outcomes

Slightly longer healing time

Patellar Tendon Autograft

Patellar tendon from the patient's own knee

Strong initial fixation, often chosen for high-demand athletes

Higher risk of front-of-knee pain and kneeling discomfort

Quadriceps Tendon Autograft

Quadriceps tendon from the patient's own knee

Larger graft diameter, useful for some revision procedures

Larger incision with temporary thigh weakness or discomfort

Allograft

Donor tendon

No tendon harvest, shorter operation

Higher re-tear risk in younger, active patients

Patient Profile	Factors That May Support Consideration of ACL Reconstruction
Competitive or recreational athletes	Knee instability following an ACL tear, particularly when the individual wishes to return to sports involving cutting, pivoting or jumping
Physically active adults (any age)	Persistent instability or episodes of the knee giving way that continue to limit daily activities or exercise despite appropriate rehabilitation
Individuals with combined knee injuries	An ACL injury accompanied by meniscal, cartilage or other knee injuries that may influence the overall treatment approach
Individuals who have not improved with conservative treatment	Persistent knee instability despite completing an appropriate physiotherapy and rehabilitation programme
Individuals with occupational demands	Knee instability that affects the ability to perform work requiring heavy manual activity or movements that depend on knee stability

Patient Profile

Factors That May Support Consideration of ACL Reconstruction

Competitive or recreational athletes

Knee instability following an ACL tear, particularly when the individual wishes to return to sports involving cutting, pivoting or jumping

Physically active adults (any age)

Persistent instability or episodes of the knee giving way that continue to limit daily activities or exercise despite appropriate rehabilitation

Individuals with combined knee injuries

An ACL injury accompanied by meniscal, cartilage or other knee injuries that may influence the overall treatment approach

Individuals who have not improved with conservative treatment

Persistent knee instability despite completing an appropriate physiotherapy and rehabilitation programme

Individuals with occupational demands

Knee instability that affects the ability to perform work requiring heavy manual activity or movements that depend on knee stability

Step	What Happens
Anaesthesia and Preparation	General or regional anaesthesia is administered before the procedure begins.
Incision and Arthroscopy	Small incisions are made and an arthroscope is inserted into the knee to assess the injury and surrounding structures.
Graft Harvesting	A tendon graft is typically taken from the hamstring or patellar tendon. Where appropriate, a donor tendon may be used instead.
Drilling and Graft Placement	Small tunnels are created in the thigh and shin bones to position the graft in place of the injured ACL.
Fixation	The graft is secured using screws or other fixation devices to provide stability.
Closure and Recovery	The incisions are closed and the knee is bandaged before the patient is transferred to the recovery area.

Step

What Happens

Anaesthesia and Preparation

General or regional anaesthesia is administered before the procedure begins.

Incision and Arthroscopy

Small incisions are made and an arthroscope is inserted into the knee to assess the injury and surrounding structures.

Graft Harvesting

A tendon graft is typically taken from the hamstring or patellar tendon. Where appropriate, a donor tendon may be used instead.

Drilling and Graft Placement

Small tunnels are created in the thigh and shin bones to position the graft in place of the injured ACL.

Fixation

The graft is secured using screws or other fixation devices to provide stability.

Closure and Recovery

The incisions are closed and the knee is bandaged before the patient is transferred to the recovery area.

General Timeline	What to Expect
Early Recovery	First few weeks	Rehabilitation focuses on managing pain and swelling, restoring knee movement and gradually improving mobility. Crutches may be used initially and reduced as advised.
Strength and Mobility	Around 1-3 months	Physiotherapy progresses to strengthening, balance and movement exercises as knee function improves.
Return to running	Around 3 months onwards	Running may be introduced when appropriate strength, movement and knee control have been regained.
Sport-Specific Training	Around 6 months onwards	Sport-specific exercises and non-contact training may be introduced as strength, stability and confidence improve.
Return to Sport	Often 9–12 months or longer	Return to competitive or pivoting sports is considered after assessment of strength, function, knee stability and readiness to return.

General Timeline

What to Expect

Early Recovery

First few weeks

Rehabilitation focuses on managing pain and swelling, restoring knee movement and gradually improving mobility. Crutches may be used initially and reduced as advised.

Strength and Mobility

Around 1-3 months

Physiotherapy progresses to strengthening, balance and movement exercises as knee function improves.

Return to running

Around 3 months onwards

Running may be introduced when appropriate strength, movement and knee control have been regained.

Sport-Specific Training

Around 6 months onwards

Sport-specific exercises and non-contact training may be introduced as strength, stability and confidence improve.

Return to Sport

Often 9–12 months or longer

Return to competitive or pivoting sports is considered after assessment of strength, function, knee stability and readiness to return.

ACL Reconstruction Surgery in Singapore

What Is ACL Reconstruction?

What Are The Graft Options For ACL Reconstruction?

When Is ACL Reconstruction Recommended?

Who Is ACL Reconstruction Suitable For?

To Find Out If ACL Reconstruction May Be Appropriate For You, Contact Us To Arrange An Assessment And Discuss The Most Appropriate Treatment Options.

How Is ACL Reconstruction Performed?

What Happens Before And After ACL Reconstruction?

Before Surgery

After Surgery

What Are The Risks And Complications Of ACL Reconstruction?

Rebuilding Strength And Stability After An ACL Tear With Dr Alan Cheung

FAQs About ACL Reconstruction Surgery