Best Hospital for Arthroscopic ACL Reconstruction Surgery in Chandigarh Tricity: Healing Hospital

Hamstring Autograft 

Tendons harvested from patient's own hamstring muscles (semitendinosus and gracilis), folded to create strong 4-strand graft, excellent strength matching native ACL, minimal anterior knee pain post-operatively, preferred for young active patients and athletes, faster recovery, Dr. Gill's preferred technique for most patients.

Bone-Patellar Tendon-Bone (BPTB) Autograft

Middle third of patellar tendon harvested with bone blocks from patella and tibia, considered "gold standard" traditionally with bone-to-bone healing, very strong initial fixation, slightly higher risk of anterior knee pain and kneeling discomfort, preferred for high-demand athletes requiring fastest return to contact sports.

Quadriceps Tendon Autograft

Portion of quadriceps tendon harvested, increasingly popular option, excellent strength, versatile graft suitable for revision cases, minimal donor site morbidity, good option when hamstring/patellar tendon unsuitable.

Allograft (Donor Tissue)

Cadaveric tissue from tissue bank, avoids donor site morbidity (no harvest site pain), longer surgical time saved, preferred for older, less active patients or revision surgeries, slightly higher re-tear risk in young active patients, longer incorporation time.

Single-Bundle vs. Double-Bundle Technique

Single-bundle is a standard technique reconstructing ACL with single graft, proven excellent outcomes, simpler procedure. Double-bundle is an advanced technique reconstructing both anteromedial and posterolateral bundles separately, theoretically more anatomic, technically demanding, and controversial whether superior outcomes justify complexity.

Before Procedure

Pre-Operative Optimisation Rehabilitation before surgery (prehabilitation)

Reducing swelling, restoring full knee extension (critical for post-op outcomes), strengthening quadriceps and hamstrings, improving range of motion along with medical clearance and surgical planning are done.

Day Before Surgery

Fasting 6-8 hours before surgery, pre-operative medications as instructed, arrangement of post-operative assistance, ice machine or cold therapy preparation, comfortable loose clothing for discharge. 

During Procedure

Anaesthesia & Positioning

General anaesthesia, patient positioned supine on operating table, thigh tourniquet applied (bloodless surgical field improving visualisation), leg prepared and draped sterile.

Diagnostic Arthroscopy

Small arthroscopic portals created, arthroscope (camera) inserted visualising entire knee joint, systematic examination confirming ACL tear, assessing menisci (cartilage cushions), evaluating articular cartilage condition, & identifying associated injuries.

Graft Harvesting 

Depending on graft type selected: hamstring tendons harvested through small incision (3-4cm) below knee and folded into 4-strand graft; patellar tendon middle third harvested with bone blocks from patella and tibia; or pre-prepared allograft tissue thawed (no harvest incision needed).

Bone Tunnel Preparation

Torn ACL remnants cleaned from knee, anatomic ACL footprints identified on femur and tibia, specialised guides position drills, femoral and tibial tunnels drilled at precise anatomic locations, tunnels sized to match graft diameter.

Graft Passage & Fixation

Graft passed through the tibial tunnel into the femoral tunnel, tensioned with knee extended, femoral fixation secured first (interference screw or cortical button), tibial fixation secured second, graft position and tension verified arthroscopically.

After Procedure

Recovery Room 

Gradual awakening from anaesthesia, pain management with medications, ice therapy continuous, leg elevation, neurovascular checks (ensuring blood flow, nerve function intact), gentle ankle pumps encouraged preventing blood clots.

Hospital Stay

Overnight observation typical ensuring comfort, adequate pain control, no complications, physical therapy initiated day of surgery or next day—teaching crutch walking, straight leg raises, ankle pumps, continuous passive motion (CPM) machine if used, discharge once mobile on crutches, pain controlled, understands home instructions.

Graft Failure/Re-Tear (3-5%)

The most concerning complication is reconstructed ACL tears again – if returning to sports too early (before 9 months), inadequate rehabilitation, traumatic re-injury, young age (<20 years), or technical errors (tunnel malposition, inadequate fixation).

Nerve Injury (1-3%)

Saphenous nerve injury during portal creation or graft harvest causes numbness on the medial side of the shin (area below the knee on inside), usually temporary.

Blood Clots (DVT/PE, <1%)

Deep vein thrombosis (leg clot) or pulmonary embolism (lung clot), rare with knee surgery compared to hip, prevented by early mobilisation, ankle pumps, sometimes anticoagulation in high-risk patients, presents as calf pain/swelling, shortness of breath.

Anterior Knee Pain (10-20%)

More common with patellar tendon graft (anterior knee pain, kneeling discomfort), less common with hamstring graft, usually mild and manageable, rarely limits function, improves over time (months to years).