Minimally Invasive ACL Reconstruction
What is it ?
Minimally invasive ACL reconstruction is an advanced surgical procedure focused on restoring knee stability by replacing the torn anterior cruciate ligament with a new graft while preserving healthy surrounding tissues. The surgery is performed through small keyhole incisions, significantly minimizing tissue trauma and promoting faster recovery. Refined and perfected by Dr. Samih Tarabichi over more than two decades of expertise, the technique avoids extensive muscle disruption, maintaining the knee’s natural biomechanics. The damaged ligament is carefully removed and replaced with a strong biological graft, precisely positioned to replicate the original ACL function and restore joint stability. The incisions are then closed using specialized methods designed to support rapid healing and early rehabilitation. This innovative approach delivers accuracy, durability, and quicker return to sports and daily activities, setting a new standard in modern ligament reconstruction surgery.
When the surgery is recommended?
There are several reasons why Dr. Tarabichi may recommend ACL reconstruction surgery. Patients who benefit most from this procedure often experience: Knee instability or a feeling of the knee “giving way,” especially during walking, sports, or sudden movements, which affects daily activities and confidence in movement. Persistent knee pain, swelling, or stiffness following an ACL injury that does not improve with rest, rehabilitation, or conservative treatments. Difficulty returning to physical activities, sports, or an active lifestyle due to reduced knee strength and control. Repeated knee injuries or cartilage damage caused by untreated ligament instability. Failure to achieve sufficient improvement with non-surgical treatments such as physical therapy, bracing, anti-inflammatory medications, or activity modification.
Is it suitable for your age?
There are no strict age or weight limitations for ACL reconstruction surgery. The decision to proceed with surgery is based on the level of knee instability, functional limitation, activity goals, and overall impact on quality of life rather than age alone. ACL reconstruction is commonly performed in adolescents, young adults, and active individuals; however, orthopedic surgeons evaluate each patient on an individual basis. Successful ACL surgeries have been carried out across a wide age range—from young athletes with sports injuries to older patients who remain physically active or experience significant knee instability. The primary objective is to restore knee stability, prevent further joint damage, and enable patients to safely return to daily activities and sports, regardless of age.
What are the preparation steps for the procedure ?
Before the surgical procedure, the patient undergoes a comprehensive assessment by a specialist in internal medicine and an anesthesiologist. Extensive laboratory tests are conducted to evaluate most of the body’s vital functions to determine the feasibility of performing the surgery.
How its done?
There are three basic steps to minimally invasive ACL reconstruction surgery:
- Prepare the knee: The damaged anterior cruciate ligament (ACL) is carefully removed, and the knee joint is cleaned of any loose tissue or debris while preserving healthy structures.
- Create and position the graft: Small tunnels are precisely created in the femur and tibia, and a strong biological graft (usually taken from the patient’s own tissue or a donor) is positioned to replicate the natural ACL’s function and alignment.
- Secure the new ligament: The graft is firmly fixed in place using advanced surgical fixation devices, allowing it to integrate with the bone and restore knee stability for smooth, controlled movement.
Robotic and Artificial Intelligence Systems: Available in the operating rooms, Dr. Tarabichi uses robotic and AI technology when needed or requested by the patient.
What About the Surgical Procedure and Recovery Period?
ACL reconstruction surgery typically takes about one hour to complete. In addition, there is preparation time in the operating room, which usually lasts approximately one hour to ensure proper positioning, anesthesia, and use of advanced surgical equipment for maximum safety and precision.
After the procedure, the patient is transferred to the recovery room for close observation for about one hour before being moved to their hospital room. In some cases, short-term monitoring may be required based on the patient’s condition.
Most patients are encouraged to begin gentle movement and weight-bearing with the assistance of crutches or a knee brace on the same day or the day following surgery. Hospital stay is usually short, often as a day-case procedure or one overnight stay, depending on individual recovery and medical assessment.
Upon discharge, patients receive detailed instructions on wound care, pain management, and a structured physiotherapy rehabilitation program at our specialized center, along with guided home exercises. With consistent rehabilitation, most patients progressively regain strength, stability, and mobility, enabling a safe return to daily activities and sports over time.
What About Rehabilitation After the Surgery?
Physical therapy is a critical phase that complements ACL reconstruction surgery and plays a major role in restoring knee stability, strength, and full functional movement. A structured rehabilitation program is essential to help patients safely return to daily activities and sports, under the supervision of highly skilled physiotherapists specialized in ligament and sports injury recovery.
Patients are strongly encouraged to fully commit to their personalized physiotherapy program, which is carefully designed according to each individual’s physical condition, mobility goals, and activity level.
To ensure optimal recovery in the shortest possible time, our rehabilitation department is equipped with the latest advanced physiotherapy technologies and training tools. The program focuses on restoring muscle strength, ligament flexibility, joint stability, balance, and pain-free movement, enabling patients to regain confidence and performance safely and efficiently.
What to Expect after the minimally invasive ACL Reconstruction?
"Realistic activities following the surgery include unlimited walking, swimming, golf, driving, light hiking, biking, ballroom dancing, and other low-impact sports"
The Video from the AAOS youtube channel
Frequently Asked Questions about Minimally Invasive Knee replacement Surgery
Initial recovery usually takes a few weeks, during which swelling decreases and basic movement improves. Most patients return to daily activities within 4–6 weeks. Full recovery, including return to sports, typically takes 6–9 months depending on rehabilitation progress and individual healing.
ACL reconstruction provides long-lasting knee stability for most patients when combined with proper rehabilitation. The graft becomes integrated into the body over time, functioning like a natural ligament. Maintaining strength and following activity guidelines helps ensure durability.
Low-impact activities can usually resume within a few months. High-impact or pivoting sports typically require 6–9 months of rehabilitation and medical clearance to ensure the knee is strong and stable enough for safe return.
In most cases, the new ACL is created using a graft taken from the patient’s own tissue (such as the hamstring or patellar tendon). In some situations, a donor graft may be used. Dr. Tarabichi selects the most suitable option based on the patient’s age, activity level, and knee condition to ensure optimal strength and long-term stability.