Anterior cruciate ligament repair can be performed using ‘open’ surgery, but generally most surgeons will use the ‘arthroscopic’ technique. This type of ACL repair makes it easier to see the procedure, uses smaller incisions and carries fewer risks. You will be placed under a general or spinal anesthesia during surgery. Several small incisions will be made around the knee and a saline solution inserted to clean and expand the area. An arthroscope – a tube with a camera attached – is then pushed through one of the incisions, allowing your surgeon to view the procedure on a TV screen. Holes are then drilled through the incisions and the knee joint, and into the upper and lower leg bones. The tissue graft, which may be taken from the patient or a deceased donor, is then pushed through the holes using special instruments and positioned to replace the old ligament, before being secured at each end using screws or staples. If any other damage has occurred, your surgeon can usually repair this during the same operation. The incisions are then closed and wrapped in bandages.