ACL Reconstruction
Surgical repair of a torn anterior cruciate ligament, performed by a senior orthopaedic specialist with over 30 years of experience.
A pop. A swollen knee. A sudden feeling that something significant just happened. ACL injuries usually come out of nowhere - a side-step on the netball court, a tackle on the footy field, a fall on the slopes — and they often need surgery to get the knee back to full function.
Dr Elie Khoury performs ACL reconstruction as part of a considered, evidence-based practice. Not every ACL tear needs surgery. When it does, the technique, the graft choice and the rehab program all matter for the long-term outcome.
What Is The ACL And Why Does It Matter?
The anterior cruciate ligament (ACL) is one of the main ligaments inside the knee. It connects the thigh bone (femur) to the shin bone (tibia) and stops the shin bone from sliding too far forward. It also plays a major role in keeping the knee stable when you twist, cut or pivot.
When the ACL tears, the knee can lose that stability. Some people manage well without it (especially if they avoid twisting and pivoting sports). Others find the knee gives way during everyday activities, not just sport. Over time, repeated instability can damage the cartilage and meniscus inside the knee, which raises the risk of arthritis later in life.
ACL reconstruction is an operation that rebuilds the torn ligament using a graft. Once healed, the new ligament restores stability and gives the knee back its ability to handle twisting, cutting and pivoting movements.
When ACL Reconstruction Is Recommended
Not every ACL tear needs surgery. The right decision depends on your age, your activity level, the type of sport or work you do, and how your knee is behaving.
You may be a candidate for ACL reconstruction if:
You've torn your ACL (usually confirmed on MRI)
Your knee feels unstable or gives way, even during regular activities
You want to return to sports that involve twisting, cutting or pivoting (football, netball, basketball, soccer, skiing, tennis)
You have a physically demanding job that requires a stable knee
Other structures in the knee (meniscus, cartilage) need treatment at the same time
Non-surgical management has been tried and your knee still doesn't feel stable
In some cases, especially in older patients or those who don't do high-demand activities, non-surgical management (physiotherapy, activity changes) can be a reasonable alternative.
Dr Khoury will give you an honest view of the right path for your knee and your life.
Dr Khoury's Approach to ACL Reconstruction
ACL reconstruction is a well-established operation, but the details matter. The choice of graft, the placement of the new ligament, the management of other injuries inside the knee, and the structure of your rehab all affect the long-term outcome.
Dr Khoury's approach is built around three principles.
The right operation for the right knee Not every ACL tear needs reconstruction. The decision should be based on your knee, your goals and your life, not on a one-size-fits-all rule. If your knee suits non-surgical management, you'll be told. If reconstruction is the right call, you'll be walked through the reasons.
Considered, evidence-based technique Dr Khoury uses contemporary technique grounded in the current evidence base. That includes graft selection (the tissue used to rebuild the ligament), tunnel placement (where the new ligament is anchored), and the management of any other injuries inside the knee at the same operation.
Rehab is half the operation ACL reconstruction is a surgery and a rehab program, not a surgery alone. The structured rehab that follows surgery is just as important as the operation itself. Dr Khoury works closely with experienced sports physios to guide you through each stage of recovery.
What To Expect - Before, During and After
Before surgery Once you've decided to go ahead, you'll meet with Dr Khoury's pre-surgery team. ACL reconstruction is usually planned with imaging already in hand, but additional tests may be requested.
You may be asked to:
Have any final imaging and blood tests done
Stop or adjust some medications
See a sports physio before surgery, to start strengthening the muscles around your knee. This is called "pre-hab" and it makes a real difference to your recovery.
Arrange transport home after surgery and support for the first one to two weeks
Surgery day ACL reconstruction is usually performed under general anaesthetic. The procedure typically takes 1 to 2 hours, depending on what else is being treated in the knee.
The operation is done through small incisions (keyhole technique). A graft (a piece of tissue, usually taken from another tendon in your knee or thigh) is used to rebuild the torn ligament. The new ligament is anchored into the bone at both ends using small fixation devices.
Dr Khoury operates at:
Cabrini Malvern
The Alfred Hospital (private patients)
The Bays Hospital (Mornington Peninsula)
Insight Private Hospital
Most patients go home the same day or after one overnight stay.
Early recovery (weeks 1 to 6) Most patients use crutches for the first 1 to 2 weeks. How much weight you can put through the leg depends on what else was treated at the same operation. Physio starts within the first week and is the most important part of recovery.
Typical milestones:
Weeks 1 to 2: Crutches. Gentle range of motion exercises. Basic daily activities.
Weeks 3 to 6: Progressive weight-bearing. A structured physio program. Many patients off crutches by 3 to 4 weeks.
Week 6: Many patients return to driving (once Dr Khoury clears you).
Full recovery (6 to 12 months) Returning to sport after ACL reconstruction takes time. Most patients return to running by around 3 to 4 months, depending on rehab progress. Return to twisting, cutting and pivoting sport is usually 9 to 12 months, and only after passing return-to-sport testing. Going back too early raises the risk of re-injury.
Frequently Asked Questions
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No. Once an ACL is torn, it doesn't heal back to its original strength. The knee can be managed without surgery in some patients (with physiotherapy and activity changes), but the ligament itself doesn't repair.
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Not always. Whether you need surgery depends on your age, your activity level, the type of sport or work you do, and how stable your knee feels. Dr Khoury will give you an honest view of the right path for your situation.
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There are several options, including hamstring tendon, patellar tendon, quadriceps tendon and donor (allograft) tissue. Each has advantages and trade-offs. Dr Khoury will discuss which is most appropriate for your knee at your consultation. [SIGN-OFF]
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Return to twisting, cutting and pivoting sport is usually 9 to 12 months after surgery, and only after passing return-to-sport testing. Earlier return is sometimes possible for non-pivoting sport. Going back too early is one of the main reasons ACL reconstructions fail.
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Many patients achieve excellent function after ACL reconstruction. A reconstructed knee is rarely identical to an uninjured knee, but with good surgery and structured rehab, most patients return to the activities they want to do.
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Yes. Re-injury is a real risk, especially in the first year after surgery and in patients who return to twisting and pivoting sport. Return-to-sport testing and ongoing strength work reduce the risk.
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Yes. To see Dr Khoury, a referral from your GP is required. Once you have it, our rooms will help you book a consultation that suits you.
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Dr Khoury consults at three locations: St Kilda Road Melbourne, the Mornington Peninsula at The Bays Hospital, and Albury at the Gardens Specialist Centre. Our team will help you find the most convenient one.
Dr Khoury’s Approach to ACL Reconstruction
An ACL injury is a significant event, but it doesn't have to define your knee. Whether the right answer for you is surgery, non-surgical management, or a combination, Dr Khoury and his team will walk you through the options honestly. The goal is the right operation for the right knee, followed by the rehab program that gets you back to the things you love.
To book, you'll need a referral from your GP. If you don't have one yet, your GP can refer you directly to Dr Khoury at any of our three locations.