An injury of the anterior cruciate ligament (ACL) is a common trauma, especially in active people who often do sports. Most cases are eligible for surgery. There are many ways to perform the operation. One of them is to collect the tendons of the gracilis and semitendinosus muscles from the patient and use them to reconstruct the ACL. With proper preparation of the graft, its durability is as high as that of a healthy ACL. The ligaments connect bones to each other. The ligament located in the knee joint starts at the thigh and ends at the tibia. Medially, slightly to the back of the thigh, there are muscles, the tendons of which are taken for the graft – gracilis and semitendinosus. Their points of insertion are located below the knee, on the tibia. The function of the muscles is to bend the limb at the knee.


Sports trauma is the most common cause of anterior cruciate ligament damage. Sports in which there is a sudden change in the direction of movement dominate, e.g. football and skiing.


An injury of the cruciate ligament causes joint instability. In the acute phase, there is also swelling and pain, often with the limited mobility. The symptoms are significantly influenced by the condition of the remaining articular structures – menisci, cartilage and other ligaments, often also damaged during an injury.


The initial diagnosis is often made after taking medical history and performing a clinical examination, it is confirmed by a diagnostic examination – magnetic resonance imaging of the knee.


In most cases, the treatment is surgical. The main goal of the operation is to restore the ACL function, i.e. to prevent excessive shifting of the tibia forward in relation to the femur – improving the stability of the knee.

Type of operation

The operation is performed by arthroscopy. In addition to two arthroscopic portals done in typical places, a third, longer (about 3-4 cm) incision is made below the knee – this is necessary to collect the tendons for transplantation. When preparing the graft for reconstruction, the doctor assesses the joint, treats other injuries (for example, meniscus damage) and prepares the site for a new ligament – removes the remains of damaged ACL, and carefully plans the location of the graft. Then, using arthroscopic portals and the site after tendon collection, the doctor drills canals in the femur and tibia and places the previously prepared graft in the appropriate position. After fixing the graft and controlling its function, the wounds are sutured, the drains are placed and a sterile dressing is applied. Usually, in the operating theater, a joint orthosis is put on.

Postoperative period

In most cases, the day after surgery, drains are removed and the patient gets out of bed with the help of elbow crutches. The operated limb is held in an orthosis. If everything is fine, the patient is discharged from the hospital. Rehabilitation should begin as soon as possible. Rehabilitation after reconstructive surgery is crucial. It should start within 5 days of the procedure.

In the Szpital Zakonu Bonifratrów, reconstructions of the cruciate ligaments are performed by a team of specialists in orthopedics and traumatology:

Stanisław Szymanik, MD – Head of the Diagnostic and Treatment Department

Michał Latos, MD

Michał Starmach, MD


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