ACL Reconstruction Surgery in India – Evidence-Based Overview

Anterior Cruciate Ligament (ACL) injury is one of the most common causes of knee instability among active individuals in India. ACL reconstruction is a proven surgical procedure aimed at restoring knee stability, function, and long-term joint health.

This page presents an evidence-based overview of ACL reconstruction in the Indian population, focusing on surgical decision-making, outcomes, and recovery.

When Is ACL Reconstruction Required?

ACL reconstruction is typically advised when:

  • Knee instability affects daily activity or sports
  • Recurrent giving-way episodes occur
  • Associated meniscal or cartilage injury is present
  • Conservative treatment has failed

In India, delayed presentation is common, increasing the risk of secondary knee damage.

Surgical Techniques Used in ACL Reconstruction

Modern ACL reconstruction is performed arthroscopically using minimally invasive techniques. The procedure involves:

  1. Removal of the torn ligament
  2. Graft placement through anatomically positioned tunnels
  3. Secure fixation to restore biomechanical stability

Technique selection depends on patient anatomy, activity level, and injury pattern.

ACL Graft Options Commonly Used in India

  • Hamstring tendon graft
  • Patellar tendon graft (BTB)
  • Quadriceps tendon graft
  • Allograft (select cases)

Each graft option has specific advantages and limitations. Graft choice should be individualized rather than standardized.

Recovery and Rehabilitation

Successful ACL reconstruction depends as much on rehabilitation compliance as on surgical technique.

Typical Recovery Milestones

Walking without support:

2–4 weeks

Strength recovery:

3–4 months

Return to sports:

8–12 months (criteria-based)

Note: Poor rehab adherence is a major contributor to graft failure in Indian patients.

Outcomes of ACL Reconstruction in Indian Patients

When performed with:

  • Proper patient selection
  • Anatomical technique
  • Structured rehabilitation

ACL reconstruction demonstrates:

High functional recovery

Low revision rates

Durable knee stability

Long-term outcomes depend on activity modification and compliance.

Revision ACL Reconstruction

Revision surgery may be required due to:

  • Graft rupture
  • Tunnel malposition
  • Premature return to sport
  • Poor rehabilitation adherence

Revision ACL surgery is technically demanding and requires careful planning.

Conclusion

ACL reconstruction in India has evolved significantly with modern arthroscopic techniques. Optimal outcomes depend on surgical precision, rehabilitation discipline, and realistic expectations.

This page is intended to provide clarity for patients and referring clinicians seeking evidence-based understanding of ACL reconstruction.

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