Can I drive after surgery?
Whether you can drive after ACL reconstruction surgery depends on several factors, including which leg was operated on, your type of vehicle, and how well you’re recovering. If the surgery was on your left knee and you drive an automatic car, you may be able to return to driving sooner than someone who had surgery on the right knee or drives a manual vehicle.
Generally, most people are advised to avoid driving for at least two to six weeks after surgery. The key consideration is whether you can safely and confidently perform an emergency stop. This requires adequate strength, reaction time, and control of your leg, especially if the right knee was involved.
You’ll also need to be off strong pain medications like opioids, which can impair reaction times and judgment. Your ability to operate the pedals smoothly and without hesitation is essential for safety—not just for you, but for others on the road.
It’s important to speak with your orthopaedic surgeon and physiotherapist before resuming driving. They’ll assess your range of motion, strength, and coordination to help determine when it’s safe to get back behind the wheel. Until then, arranging alternative transport is the safest approach.
How can I prepare for surgery?
Preparing for ACL reconstruction surgery involves both physical and practical steps to ensure the best possible outcome. One of the most beneficial things you can do is begin a physiotherapy program before the operation, often referred to as “prehab.” This helps reduce swelling, restore knee motion, and strengthen the surrounding muscles, all of which can lead to a smoother recovery after surgery.
You’ll also need to attend a pre-operative assessment, where your overall health will be evaluated. This might include blood tests, imaging (like an MRI), and a review of your medical history. You’ll be given instructions about fasting—typically no food or drink for several hours before the procedure—and guidance on medications. Some medications, especially blood thinners or anti-inflammatories, may need to be paused ahead of time.
It’s a good idea to organise your home environment in advance. Set up a comfortable resting area on the ground floor if stairs will be difficult, and ensure you have easy access to essentials like ice packs, compression bandages, and pain relief medications. Arrange for time off work, help with daily activities, and transport to and from the hospital, as you won’t be able to drive for a while.
Preparing mentally is just as important—understanding what to expect and setting realistic recovery goals will help you stay motivated throughout the process.
How long does surgery take?
ACL reconstruction surgery typically takes about 60 to 90 minutes to complete. However, the exact duration can vary depending on several factors, including the complexity of the injury, the type of graft being used, and whether any additional procedures (like meniscus repair) are performed at the same time.
The surgery is most often done using minimally invasive arthroscopic techniques, which involve small incisions and the use of a camera to guide the procedure. This approach tends to be more efficient and allows for quicker recovery compared to traditional open surgery.
Before the procedure begins, there’s also preparation time in the operating theatre, including administering anaesthesia and positioning the patient, which adds to the overall time spent in the hospital. Most patients can expect to be at the hospital for several hours on the day of the surgery, even though the procedure itself is relatively short.
While the surgery may not take very long, it’s important to understand that recovery is a much longer process. Regaining strength, stability, and full function in the knee can take several months, and patients must be committed to a structured rehabilitation program for the best outcome. The operation may be brief, but its success depends greatly on the post-operative recovery.
How soon can I return to sports or work?
The timeline for returning to sports or work after ACL reconstruction varies widely depending on your job, sport, and how well your knee heals. For most people, returning to desk-based or sedentary work is possible within 2 to 3 weeks, especially if the job doesn’t require standing or walking for long periods. However, jobs that involve manual labour, climbing, or kneeling may require at least 3 to 4 months before a safe return.
When it comes to sport, the timeline is longer. Low-impact activities like cycling or swimming can often be reintroduced around the 3-month mark, depending on your progress and the advice of your physiotherapist. Running typically comes around 4 to 6 months post-surgery, but pivoting or contact sports—like football, netball, or basketball—require more time.
A full return to competitive sports generally takes 9 to 12 months, sometimes longer. This isn’t just about healing the graft; it’s about regaining full strength, coordination, and confidence in the knee. Attempting to return too soon increases the risk of re-injury, either to the reconstructed ligament or other parts of the knee.
Clearance from your orthopaedic surgeon and performance testing through your physiotherapist are important steps before resuming high-level activity.
What are the potential risks?
Like any surgical procedure, ACL reconstruction comes with potential risks, although serious complications are relatively uncommon. The most common concerns include infection, blood clots, and bleeding or bruising around the surgical site. There's also a small risk of nerve or blood vessel injury, though this is rare given the minimally invasive techniques typically used.
One of the more specific risks is graft failure, where the new ligament either doesn’t heal properly or re-tears. This can happen if the knee is injured again during recovery or if the graft doesn't incorporate well into the bone. It's a more significant concern for those returning to high-risk sports too early.
Some patients experience stiffness or reduced range of motion, especially if early rehabilitation is delayed. Others may have ongoing swelling or a sensation of instability, even after the graft heals. Pain around the front of the knee—particularly when using a patellar tendon graft—is another possible issue.
In rare cases, patients may develop arthrofibrosis, a condition where excessive scar tissue limits movement. There’s also a long-term consideration: people who’ve had an ACL injury, with or without surgery, are at increased risk of developing osteoarthritis in the knee later in life.
Good surgical technique, adherence to rehab, and avoiding premature return to sport all help minimise these risks.
What is the recovery time?
Recovery time after ACL reconstruction varies from person to person, but most people can expect it to take between 6 and 12 months to return to full activity. In the early weeks following surgery, the focus is on reducing pain and swelling, regaining knee movement, and starting basic muscle strengthening. Crutches are often used during this period, and most patients can bear weight on the leg gradually, depending on their surgeon’s advice.
By around three months, many people begin more advanced physiotherapy exercises aimed at improving strength, balance, and agility. Activities like stationary cycling or light jogging may be introduced as long as the knee is stable and not painful. However, full return to sports—especially those involving pivoting, cutting, or jumping—typically takes 9 to 12 months, sometimes longer. This is because the graft used to reconstruct the ACL needs time to fully incorporate and become as strong and functional as the original ligament.
Returning too soon can significantly increase the risk of re-injury, either to the graft or to other structures in the knee. Regular follow-up with your orthopaedic surgeon and physiotherapist is essential to monitor your progress and make sure you're meeting the right milestones safely along the way.
What type of anesthesia is used?
ACL reconstruction surgery is usually performed under general anaesthesia, which means the patient is completely unconscious during the procedure and does not feel any pain. In some cases, a regional anaesthetic—such as a spinal or epidural block—may be used, either alone or in combination with general anaesthesia. These regional techniques numb the lower half of the body and can provide excellent pain control during and after the operation.
Another option sometimes used is a nerve block, such as a femoral or adductor canal block. These are local anaesthetic injections that specifically target the nerves supplying the knee, offering targeted pain relief without affecting the entire body. Nerve blocks are often combined with general anaesthesia to improve post-operative comfort and reduce the need for strong pain medications like opioids.
The choice of anaesthesia depends on the patient’s medical history, preferences, and the anaesthetist’s recommendation. Before surgery, the anaesthetist will discuss all options and help decide what’s safest and most effective for the individual. Regardless of the approach, modern anaesthetic techniques are highly safe and tailored to ensure patient comfort, both during the operation and in the immediate recovery period.
Will I need physiotherapy after surgery?
Yes, physiotherapy is an essential part of recovery after ACL reconstruction surgery. In fact, the success of the operation heavily depends on following a structured rehabilitation program led by a qualified physiotherapist. The main goals of physiotherapy are to reduce pain and swelling, restore full range of motion, rebuild strength, and gradually return the knee to normal function.
Rehabilitation typically begins within a few days of surgery, starting with gentle range-of-motion and muscle-activation exercises. As healing progresses, the program becomes more intensive, focusing on strengthening the quadriceps, hamstrings, and core muscles. Balance and coordination exercises are also introduced to help improve joint stability.
By around the three-month mark, more dynamic activities such as light jogging or cycling may be reintroduced, depending on the individual's progress. For athletes or those with physically demanding jobs, sport-specific or job-related training is added later in the program to ensure a safe return to full activity.
Skipping physiotherapy or doing it inconsistently can lead to stiffness, weakness, and a higher risk of re-injury. Recovery is a gradual process, often taking six to twelve months, and physiotherapy is the most effective way to support that journey and achieve the best possible outcome.
Will I regain full knee function?
Most people who undergo ACL reconstruction surgery do regain good knee function, especially if they follow a thorough rehabilitation program and avoid returning to high-risk activities too early. However, "full function" can mean different things depending on your goals—whether it's returning to elite-level sport, recreational activity, or simply walking and climbing stairs without discomfort.
The goal of surgery is to restore stability to the knee, reduce pain, and enable a return to normal activity. Many patients achieve near-normal strength and movement, but some may experience ongoing stiffness, mild instability, or occasional swelling, particularly during high-impact activities. This can be influenced by factors such as the severity of the original injury, whether other knee structures (like the meniscus or cartilage) were also damaged, and how diligently rehabilitation is followed.
Rehabilitation plays a crucial role in regaining full function. Skipping or rushing through physiotherapy can lead to suboptimal outcomes. For athletes, performance testing is often used to assess readiness before returning to sport.
While outcomes are generally very good, no surgery can guarantee a knee that feels exactly the same as before injury. Still, with commitment to recovery, most people regain the function they need for an active lifestyle without major limitations.
