The majority of patients who are active with sports or at work may require anterior cruciate ligament reconstruction. Because the ACL has a very limited blood supply, it does not heal and cannot be repaired or stitched together. Surgical treatment then requires reconstruction of the ligament using a graft taken from your own body (autograft). The most appropriate type of graft for any individual patient is determined through an evaluation and discussion with your sports medicine physician. The appropriate graft is then threaded through the knee joint with the help of arthroscopic tools and placed where the normal anterior cruciate ligament was.
The graft is secured to both the thigh bone and the lower leg bone and then biologically heals in to 
become the anterior cruciate ligament over the following months. Any other injuries to the knee joint are also arthroscopically evaluated and treated at the same time. This outpatient procedure often requires a period of bracing followed by a structured physical therapy program. Return to such activities as biking may occur within the first 3 to 6 weeks, treadmill running by 10 to 12 weeks, outdoor running by 3 to 4 months, and full unlimited pivoting type sports by 6 to 8 months. Anterior cruciate ligament reconstruction allows active athletic people to return to their pre-injury level of life on a consistently high basis.
The standard ACL reconstruction has provided great stability to knee but has been now proved to not halt progression of osteoarthritis. So, in order to provide stability to knee and also prevent or retard the development of osteoarthritis, a new concept with ACL evolved around mid of 2005 in USA. This new concept is called the Anatomical Reconstruction of ACL. With the advent of higher technology in arthroscopy, it became very safe to go into highly difficult places in the knee.
We routinely not just do Anatomical ACL reconstruction with Bone tendon Bone graft but also Hamstring tendons are used. In patient whose graft quality is good and not yet any osteoarthritis, knee is considered for Anatomical double bundle ACL reconstruction.
