ACL Reconstruction Surgery in Ludhiana
An ACL tear is one of the most common sports injuries affecting athletes and active individuals. A torn ACL causes instability, repeated giving way of the knee, and increases the risk of meniscus and cartilage damage. At Eva Hospital, arthroscopic ACL reconstruction is performed, with the technique selected according to each patient’s anatomy, sporting demands and associated injuries.
Understanding the injury
What is the ACL?
- Provides rotational stability during pivoting and cutting movements
- Prevents excessive forward movement of the tibia relative to the femur (anterior tibial translation)
- Works together with the menisci and surrounding muscles to keep the knee stable under load
How Does an ACL Tear Occur?
ACL tears commonly occur during sports or accidents that involve sudden twisting, landing or direct impact.
Sports Injuries
Twisting Injuries
Landing After a Jump
Road Traffic Accidents
Contact Injuries
Symptoms of an ACL Tear
An Audible Pop
Immediate Swelling
Instability
Knee Giving Way
Difficulty Pivoting
Reduced Confidence
Diagnosis
How is an ACL Tear Diagnosed?
History
Clinical Examination
Lachman Test
Anterior Drawer Test
Pivot Shift Test
MRI
Standing X-rays
An important distinction
Partial vs Complete ACL Tear
| Partial Tear | Complete Tear |
|---|---|
| A portion of the ligament fibres remain intact | The ligament is fully ruptured with no continuity between fragments |
| May provide some residual rotational stability | Rotational stability is lost, increasing the risk of the knee giving way |
| Selected cases may be managed without surgery, with close monitoring | Reconstruction is usually recommended for young, active patients in pivoting sports |
| Often associated with lower-energy twisting injuries | More frequently associated with meniscus and cartilage injury |
The most important question
Do All ACL Tears Require Surgery?
Conservative (Non-Surgical) Treatment
- Elderly patients
- Sedentary individuals with low functional demands
- Medically unfit patients where surgical risk is a concern
- Selected partial tears with a stable clinical examination
Complete ACL Tears in Active Patients
Risks of Prolonged Instability
Repeated Instability
Meniscus Tear
Cartilage Damage
Early Arthritis
Persistent instability of the knee may increase the risk of meniscus and cartilage injury. The timing of surgery is decided individually after clinical assessment.
Choosing the right graft
ACL Graft Options
Graft selection is individualised, taking into account the patient’s age, sport, occupation, tunnel anatomy, and any associated ligament or meniscus injury.
| Graft | Advantages | Considerations |
|---|---|---|
| Hamstring Tendon | Smaller incision, less anterior knee pain, strong graft | Some studies report slightly higher rotational laxity in certain patients |
| Bone-Patellar Tendon-Bone (BTB) | Bone-to-bone healing, popular in pivoting-sport athletes | Higher risk of anterior knee pain and kneeling discomfort |
| Quadriceps Tendon | Larger graft diameter, good option for revision surgery | Technique-sensitive harvest, can cause quadriceps-site discomfort |
| Allograft (Donor Tissue) | No donor-site morbidity, shorter surgical time | Generally reserved for older, lower-demand patients due to a higher re-tear risk in young athletes |
Often overlooked, always important
ACL Fixation Methods
Femoral fixation options include suspensory fixation (using a button or loop on the outer bone surface) and aperture fixation (using a screw closer to the joint surface).
Tibial fixation options include interference screws, suspensory fixation, and hybrid techniques combining more than one method.
Graft augmentation
Internal Bracing / Graft Augmentation
- A strong suture tape placed alongside the graft to share load during early healing
- May protect the graft while it biologically incorporates in the first few months
- Often considered in revision ACL surgery
- Sometimes used in high-demand athletes returning to pivoting sport
Preserving the meniscus
Meniscus Injuries with ACL Tears
A significant proportion of ACL injuries have an associated meniscus tear. The meniscus acts as a shock absorber for the knee, so preserving it matters for long-term joint health.
- Repair is performed whenever the tear pattern and blood supply allow it
- Meniscectomy (trimming) is reserved for tears that cannot be repaired
- Meniscus treatment is planned alongside ACL reconstruction, not as an afterthought
What to expect in the operating room
Surgical Technique, Explained Simply
Arthroscopic Assessment
Graft Harvest
Graft Preparation
Tunnel Creation
Graft Fixation
Associated Repairs
Our Doctor
Details of registered medical practitioners at Eva Hospital, Ludhiana, provided for patient information.
Dr. Tanveer Singh Bhutani
Consultant Orthopaedic Surgeon
- Qualifications
- MBBS, MS (Orthopaedics), M.Ch (Orthopaedics) (UK)
- Department
- Orthopaedics
- Registration Status
- Registered
- Registration No. (NMR/SMR)
- 40132
- Registered With
- Punjab Medical Council
- Availability
-
10:00 AM to 2:00 PM
4:00 PM to 8:00 PM
Registration can be verified on the NMC website.
The road back
Rehabilitation Timeline
Recovery follows a structured, physiotherapy-led programme rather than a fixed calendar.
| Recovery Timeline | Rehabilitation Goals |
|---|---|
| Week 1 | Pain and swelling control, gentle range-of-motion exercises, weight-bearing as advised. |
| Week 2 | Progressive range of motion, quadriceps activation, walking with support as needed. |
| Week 6 | Improved strength and balance, stationary cycling, gait normalisation. |
| 3 Months | Progressive strengthening, introduction of controlled jogging where appropriate. |
| 6 Months | Sport-specific drills, agility and change-of-direction training begin under supervision. |
| 9 Months | Functional and strength testing guide readiness; many athletes are not yet cleared to return before this point. |
| 12 Months | Full sport-specific testing and confidence-based return-to-play assessment. |
Return to sport
Return to Sports and Daily Activities
Driving
Swimming
Cycling
Gym / Squats
Running
Cricket
Football
Risks and Honest Expectations
Like any surgery, ACL reconstruction carries risks. Most patients recover well, but outcomes depend on patient factors, surgical planning and rehabilitation.
- Infection
- Re-tear of the graft
- Stiffness
- Cyclops lesion
- Deep vein thrombosis (DVT)
- Persistent instability
Our approach
Our Approach to ACL Reconstruction
Clinical Examination
Graft Selection
Associated Injuries
Associated Injury Treatment
Related Pages
Frequently Asked Questions
Selected partial tears in low-demand patients may be managed without surgery, but reconstruction is usually recommended for complete tears in active individuals because of the risk of ongoing instability.
Hamstring, BTB, quadriceps tendon and allograft each have advantages and trade-offs. The choice depends on age, sport and anatomy.
Strength depends on the combination of graft, fixation device, bone quality and tunnel position — not on any one fixation type in isolation. Your surgeon selects the method suited to your case.
Internal bracing is a useful adjunct in selected situations, such as revision surgery or high-demand athletes, rather than a universal upgrade needed by every patient.
Instability and associated meniscus or cartilage damage are known risk factors for early arthritis. Timely, Timely, appropriately planned treatment may reduce this risk, but it cannot eliminate it.
Many athletes return to football, typically after around nine months or more, once functional and strength testing confirm readiness.
Yes, squatting is reintroduced progressively during rehabilitation as strength and control improve, usually from around 3–4 months.
Controlled jogging is often introduced around 3–4 months, progressing to full running once strength and confidence criteria are met.
Most patients can resume driving once they have good knee control and are off strong pain medication, often around 4–6 weeks — always confirm with your surgeon.
This depends on how physically demanding your job is. Desk-based work may resume within 1–2 weeks; physically demanding jobs take longer.
ACL reconstruction typically takes 1–1.5 hours, though this varies if meniscus repair or other associated procedures are needed.
Many patients are discharged within 24–48 hours, depending on pain control, associated procedures, and general fitness.
Meniscus tears are treated in the same surgery whenever possible — repaired if the tear pattern allows, or trimmed if repair isn’t feasible.
Not always immediately — swelling and range of motion are often optimised with physiotherapy first (‘prehab’) before scheduling surgery.
A partial tear means some ligament fibres remain intact, which may allow some residual stability; treatment still depends on clinical assessment.
Through a combination of patient history, clinical tests (Lachman, anterior drawer, pivot shift), and MRI to confirm the tear and check for associated injuries.
Yes — structured physiotherapy before and after surgery is essential to regain strength, motion and confidence in the knee.
It is a nodule of scar tissue that can form in front of the ACL graft, sometimes limiting full knee extension and occasionally requiring a minor procedure to remove.
Yes, re-tear is a recognised risk, particularly if return to sport happens before adequate strength and control are regained.
It’s reasonable to be assessed within a few weeks of injury so that a treatment plan — surgical or non-surgical — can be individualised early.