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The old ligament is removed using a shaver or other instruments. Bone tunnels are made to place the new ligament (patellar graft) in the knee at the site of the old ACL. Screws are commonly used to secure the graft in the bone tunnels, although other methods of fixation are used depending on the type of graft used.
Review Date 6/27/2026
Updated by: C. Benjamin Ma, MD, Chair, Department of Orthopaedic Surgery, Dr. Peter and Sophie Pappas Endowed Chair, V-nee Yeh Endowed Professor of Orthopaedic Surgery, University of California, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
