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What to Expect During a Knee Ligament Repair Surgery


The knees are made up of different structures that work together to maintain strength and stability. One such example of a crucial structure is knee ligaments. Ligaments are a strong band of muscle that attach a bone to another bone. 

In the knees, the ligaments are mainly responsible for connecting the femoral head (thigh bone) to the tibia (lower leg bone). It holds these structures in place to maintain joint stability and prevent dislocations. The ligaments of the knee may be grouped into two:

  • Collateral ligaments are made up of the medial collateral ligament (MCL) and lateral collateral ligament(LCL). These two run vertically at the inner and outer sides of the knee, securely attaching the thigh bone to the calf bone.
  • Cruciate ligaments are made up of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). They can be found inside the knee joint, forming an X pattern at the front and back of the knees. 

Ligaments are strong bands of connective tissue but can still be damaged or torn. When this happens, patients often experience severe pain, especially when moving. Other symptoms include mobility problems, severe swelling, limited range of motion, and instability. 

If you have a ruptured knee ligament and are scheduled to have reconstruction surgery, then head down below to learn more.

When is a knee ligament repair needed?

Knee ligaments sustain damage mainly because of highly physical contact sports like football, basketball, and hockey. This can happen by getting a direct blow to the knee or during sudden movement (e.g., abruptly stopping or twisting). Ligament injuries may also occur during car collision accidents or knee overuse. 

Additionally, the ACL is the most common ligament to get injured or damaged, followed by the PCL, MCL, and LCL.

Orthopedic specialists can diagnose ligament injuries through symptom correlation, physical examination, and medical history review. 

Partial ligament ruptures may be treated using non-surgical options, while complete tears require surgery. However, if you have an active lifestyle or want to keep doing vigorous activities, you’ll need ligament reconstruction regardless of your injury type.

How to prepare for a knee ligament repair?

Once you’re scheduled to undergo a ligament repair surgery, your doctor may require you to do the following preparations:

  • Submit to a complete physical examination, blood test, imaging test, and cardiovascular test. This allows physicians to assess the severity of the condition and gauge whether the patient is healthy enough to undergo the procedure.
  • Discontinuing specific medications, such as aspirin. However, you may be encouraged to take nutritional supplements, such as vitamin C or multivitamins.
  • Quit or discontinue smoking and alcohol consumption for at least a week or two before the surgery.
  • Stop consuming caffeine, 
  • Undergo pre-rehabilitation therapy to decrease knee swelling and strengthen the joints.
  • Arrange for someone to drive you to and from the facility. You may also have someone to help you around the house during the first few days of your recovery.
  • Prepare your home by bringing sleeping materials downstairs so you won’t have to go up and down. You can also place frequently used items in accessible locations. 

Your surgeon will go over the entire surgical procedure and treatment plan with you. Make sure to take note of important information and ask questions about things you’re uncertain about.

What happens during the surgery?

Most knee ligament reconstruction surgery happens as an outpatient procedure. This means that the patient will be able to go home on the day of the surgery. There are various ways to perform a ligament repair, but it usually follows these steps:

Utilizing arthroscopy

  • An anesthesiologist will sedate or anesthetize the patient depending on their treatment plan. This means that the patient will either be unconscious and/or numb during the procedure.
  • Next, the surgeon will use a device called an arthroscope to view and examine the inside of the knee joint. This equipment only requires 2-3 tiny incisions for a small camera and other specialized tools to gain access inside the knee.
  • The surgeon will confirm the damaged ligament and look for other structures that may be compromised as well.

Skin grafting

  • The surgeon will then prepare the skin, which will be used to bridge the gap between the torn ligaments. Tissues may come from the patient’s own (autograft), a donor (allograft), or synthetic material. 
  • The tissues may be harvested from the patellar tendon, hamstring tendon, quadriceps tendon, or Achilles tendon.
  • The surgeon will remove the tissue from its source and cut it to its proper size.

Ligament reconstruction

Using the arthroscopic technique, the surgeon will drill holes into the thigh bone and shinbone, affix the new tissue in place, and fasten it with screws. The orthopedic specialist may also perform other reparations if needed, such as removing bone spurs. 

Once attached, the surgeon may test out the new ligament by bending or moving the knee. Once satisfied, they will close the incision and dress it with bandages.

Most knee ligament repairs take about two hours or less. However, a lot of factors can affect the surgery time, such as the severity of the condition and the type of tissue to be used.

What to expect after a knee ligament repair surgery?

After the surgery, the patient will be moved into the recovery area, where a healthcare professional will monitor their progress. Once the anesthesia wears off, the doctor will explain discharge instructions and post-op care. Some of these are as follows:

  • Proper bathing instructions and caring for the surgical site.
  • Resting the knee and limiting sudden movement or weight bearing. You may also be instructed to use crutches for the first two weeks.
  • Propping the leg on pillows at least six times daily to help reduce swelling. You may also be given pain medications to manage some side effects.
  • Your doctor will arrange for your physical therapy sessions to help augment healing. This will help you regain muscle strength, control, balance, and stability.
  • It’s important to take at least two weeks off from work or household chores until it’s safe to perform activities again.

It will take at least four weeks before you can start putting some weight on the repaired knee. By this time, you should still be actively participating in your rehabilitation and follow-up appointments.

You may be able to return to normal activities (e.g., working, driving) between the 7th to 24th week. After six months, your doctor may permit you to return to your favorite sport.

outpatient surgery center

Where to find the best outpatient surgery center?

Persistent pain in the knee is not normal, especially if it’s caused by a damaged ligament. If you are enduring such a condition, then our Raleigh orthopedic surgeons can help you get back to doing what you love.

Raleigh Orthopaedic Surgery Center is both the largest and most modern ambulatory surgery facility in Eastern North Carolina to specialize exclusively in orthopaedics. Our patients receive outstanding patient satisfaction, superior clinical outcomes, and reduced costs. 

With our care, we are with you the entire way so you can keep life even during injury. Call Raleigh Orthopaedic Surgery Center at 919-719-3070 for more information.

The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.