Knee surgery · UK
ACL reconstruction, by a high-volume knee surgeon.
A day-case arthroscopic reconstruction of the ruptured anterior cruciate ligament - done by a consultant on the BOSTAA or BASK knee register, with the graft chosen to fit you, and a nine to twelve month rehabilitation programme built into the price.
Why patients choose us
- 01
A high-volume knee surgeon, not a general orthopod
A named consultant on the BOSTAA or BASK knee register, doing at least 40 ACLs a year, with a published re-rupture rate.
- 02
Graft chosen to fit the patient, not the surgeon
Hamstring, BPTB, quadriceps or allograft. We match graft to age, sport, occupation and previous knee history rather than a one-graft habit.
- 03
Independent, and free
We are paid by no clinic and no surgeon, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private ACL reconstruction costs in the UK.
Indicative ranges across our partner units. Send the MRI report and we quote firm figures across two or three surgeon and graft options.
In short
A primary ACLR in our network: £10,500–£16,500, home the same day.
| Procedure | Indicative range | Typical duration | Admission |
|---|---|---|---|
| Consultation, MRI review and Rolimeter laxity check | £300–£500 | 45 min | Same visit |
| Primary ACL reconstruction (hamstring or quadriceps) | £10,500–£14,500 | 60–90 min | Day case |
| Primary ACL reconstruction with BPTB autograft | £11,500–£16,500 | 75–100 min | Day case |
| LET (lateral extra-articular tenodesis) add-on | £3,000–£5,000 | +20–30 min | Same admission |
| Meniscus repair at the same sitting | £2,500–£4,500 | +20–40 min | Same admission |
| Revision ACL reconstruction (single or two-stage) | £14,000–£22,000 | 90–150 min | Day case or 1 night |
Prices vary by surgeon, by hospital (Fortius, London Sports Orthopaedics, HCA The Wellington Sports and Orthopaedic, Chelsea and Westminster Private, Cromwell BUPA, One Welbeck Orthopaedic), by graft choice and by whether LET or meniscus repair is added. Most packages include a year of structured physiotherapy.
The journey
From MRI to return-to-sport - what happens, in order.
One surgical team and one physiotherapy pathway, from the first enquiry to a criterion-based return to your sport at nine to twelve months.
- 01
Before
You send us the MRI and knee history
A short, confidential form. When the knee gave way, what happened next, the MRI report and images, plus any prior arthroscopy or brace fitting.
- 02
Before
We come back with a recommendation
Within one working day: which surgeon fits the case, which graft they would use, whether LET augmentation is indicated, and an indicative price.
- 03
Before
Pre-hab, then a surgical date
Two to three weeks of pre-habilitation to settle swelling, regain full extension and switch the quads back on. Only then do we book the reconstruction.
- 04
On the day
Arrival, block and arthroscopy
Day case. General anaesthetic with a regional adductor-canal or femoral block. Diagnostic arthroscopy first to confirm the tear pattern and address the meniscus.
- 05
On the day
The reconstruction itself
Roughly 60 to 90 minutes. Graft harvest, tibial and femoral tunnel drilling, graft passage and fixation with an interference screw or suspensory device.
- 06
On the day
Home the same day, in a hinged brace
Weight-bearing as tolerated on day one with crutches for two weeks and a hinged brace for six. Written aftercare, cryotherapy cuff and physio contact details.
- 07
After
Nine to twelve months of structured rehab
Physio milestones, criterion-based testing, and a formal return-to-sport battery (hop tests, strength, Y-balance, ACL-RSI) before you pivot again.
Typical pre-hab: 2–3 weeks. Brace: 6 weeks. Return to running: 3 months. Return to pivoting sport: 9–12 months.
When it helps
When ACL reconstruction is the right step - and when it is not.
The knees we see most, plus the situations where a hinged brace, formal rehab and activity modification is a legitimate route.
-
Functional instability from an ACL rupture
Repeated giving-way on turning, cutting or descending stairs after an MRI-confirmed complete ACL tear.
-
Young, active patient with a pivoting sport
Football, rugby, netball, skiing or racket sports in someone under 30 - surgical stabilisation is usually recommended over long-term brace and rehab.
-
Concomitant meniscus tear that needs repair
A reparable bucket-handle or root tear locks in the case for early reconstruction to protect the meniscus repair.
-
Multi-ligament injury (ACL + MCL, PLC or PCL)
Combined injuries need staged or single-stage reconstruction with formal PLC or PCL work - a knee-fellowship surgeon only.
-
Failed non-operative trial after 3 to 6 months
A patient who tried bracing and rehab but still gives way, or cannot return to their sport or job.
-
High-risk knee - young, hyperlax, pivoting sport
Age under 25, generalised joint hypermobility or a high-grade pivot shift push us towards LET augmentation to cut re-rupture rates.
-
Revision ACL reconstruction
A previous ACLR that has re-ruptured or stretched out - tunnel positions, graft choice and staging all reconsidered from scratch.
-
Older sedentary patient, no giving-way
A partial or isolated ACL tear in a low-demand patient with a stable knee is often managed non-operatively with a hinged brace and rehab.
Graft and augmentation options
ACL reconstruction is a family of operations - the graft is the biggest decision.
What each graft actually involves, when LET augmentation is added, and when non-operative management is the honest recommendation.
-
Hamstring autograft (STG)
Semitendinosus with or without gracilis, quadrupled to 8 to 10 mm. The UK workhorse: minimal donor pain, small risk of hamstring tendinopathy, weaker initial fixation than bone-block grafts.
-
BPTB autograft (bone-patellar-bone)
Bone plug at each end, best return-to-elite-sport data. Donor-site anterior knee pain and difficulty kneeling are real. Favoured for pivoting-sport professionals and contact athletes.
-
Quadriceps tendon autograft
Increasingly popular. Strong graft with minimal donor morbidity, a good option for revision, for smaller hamstring tendons, and for kneeling occupations.
-
Allograft (donor tendon)
No donor-site pain, faster early recovery. Higher re-rupture rate in patients under 25, so we reserve it for older, lower-demand patients and selected revisions.
-
Synthetic (LARS)
Historical use, not first-line NHS. A small number of private surgeons still offer it in carefully selected patients who need very fast return to work - we discuss it honestly.
-
LET augmentation
A lateral extra-articular tenodesis added to a primary ACLR. Cuts re-rupture by around 40% in high-risk knees: age under 25, high-grade pivot shift, hyperlaxity, revision or contact sport.
-
Meniscus repair at the same sitting
Every reparable tear is fixed rather than trimmed - it protects the knee from osteoarthritis. Partial meniscectomy is a last resort for irreparable tears only.
-
Non-operative pathway
A hinged brace, formal quads and hamstring rehab, and activity modification. A legitimate route for older sedentary patients with a stable knee and no giving-way.
Our vetted UK network
A small panel of knee surgeons, we picked them.
Consultants with a sports-knee fellowship, high ACL case volumes and a published re-rupture rate, at Fortius, London Sports Orthopaedics, HCA The Wellington, Chelsea and Westminster Private, Cromwell BUPA and One Welbeck.
-
Consultant knee surgeons with a fellowship in sports knee and at least 40 ACLs per year
-
BOSTAA, BASK or ESSKA membership and a published re-rupture and complication rate
-
Willing to offer all four graft options rather than defaulting to one
-
Formal criterion-based return-to-sport programme with objective testing at 9 to 12 months
Safety and recovery
What to expect afterwards - honestly.
ACL reconstruction is a common, well-established operation. The things worth planning are the brace, the two-week bleeding and DVT window, the graft-specific donor issues, and the year of structured rehabilitation.
-
GA plus regional block
Standard general anaesthetic with an adductor-canal or femoral block for post-op pain control. You are usually home the same day with oral analgesia only.
-
Weight-bearing from day one
Weight-bearing as tolerated on crutches, in a hinged brace locked in extension for walking, unlocked for physio. Crutches for two weeks, brace for six.
-
Re-rupture in 3 to 6% of primary ACLRs
Higher in the under-20s, in pivoting sports and where LET was not used in a high-risk knee. Contralateral ACL rupture runs at 3 to 8% over the following decade.
-
Arthrofibrosis if operated too early
Reconstructing a hot, swollen knee within two weeks of the injury raises the risk of a stiff knee. Pre-hab is not optional - it is part of the operation.
-
Graft-specific donor-site problems
Hamstring: small risk of hamstring tendinopathy. BPTB: anterior knee pain and kneeling difficulty. Quadriceps: mild extensor lag. Allograft: none, at the cost of a higher re-rupture rate under 25.
-
Deep vein thrombosis
Small but real risk after knee surgery. Chemical prophylaxis for two weeks, calf pumps and early mobilisation reduce it further. Sudden calf swelling needs same-day assessment.
-
Osteoarthritis at 20 years
Around 40% of ACL-injured knees show radiographic osteoarthritis at 20 years, whether reconstructed or not. Meniscus preservation is the biggest modifier we can influence.
-
Return-to-sport criteria, not the clock
A limb symmetry index of 90% on hop tests, matched quads and hamstring strength, a passing Y-balance and an ACL-RSI score above 65 - not "nine months is up".
-
Red flags after discharge
Sudden calf pain or swelling, a hot swollen knee, a fever above 38C, or a knee that gives way in the brace - call the unit or attend A&E the same day.
Reading your operation note
Your ACLR op note in four parts. Read the last one first.
Whichever graft was used, the surgeon's note keeps to the same shape - and your rehab plan lives at the bottom.
- 01 Header
Graft type, size and fixation
Which graft was used, its diameter in millimetres, and whether tibial and femoral fixation was an interference screw, suspensory button or hybrid.
- 02 Technique
Tunnels, meniscus and LET
Tibial and femoral tunnel positions (anteromedial portal or transtibial), meniscus repair or partial meniscectomy, and whether LET augmentation was added.
- 03 Findings
Cartilage, collaterals and PLC
Cartilage grade (Outerbridge), status of the MCL, LCL and posterolateral corner, and any bone bruising or loose bodies.
- 04 Impression
Rehab protocol and milestones
Read this first: brace settings, weight-bearing plan, physio phase dates, return-to-run target and criterion-based return-to-sport testing.
Recognised by major UK insurers
ACL reconstruction is usually funded when medically indicated after a sports injury. Cover for LET augmentation, revision surgery and extended physiotherapy varies. We confirm cover before booking.
Frequently asked
Everything we get asked about ACL reconstruction.
Quick answers on graft choice, LET, cost, return-to-sport and re-rupture.
-
How soon after the injury should I have ACL reconstruction?
Not straight away. Operating on a hot, swollen knee within the first two weeks raises the risk of arthrofibrosis and a permanently stiff knee. The standard is two to three weeks of pre-habilitation first - settle the swelling, regain full extension and switch the quads back on - then reconstruct. Waiting a few months is fine for most patients, provided the knee is not repeatedly giving way and there is no reparable meniscus tear that needs protecting sooner.
-
Hamstring, BPTB or quadriceps - which graft is best for me?
There is no universal winner. Hamstring is the UK workhorse: small donor morbidity, good outcomes, weaker initial fixation. BPTB has the best data for return to elite pivoting sport but leaves donor-site anterior knee pain and difficulty kneeling. Quadriceps tendon is increasingly popular with minimal donor pain and a strong graft. Allograft avoids donor problems but re-ruptures more often in under-25s. We match the graft to your age, sport, occupation and previous knee history.
-
What is LET and do I need it?
LET is a lateral extra-articular tenodesis - a strip of iliotibial band routed under the LCL to control the pivot shift. Added to a primary ACLR it reduces re-rupture by around 40% in high-risk knees: age under 25, a high-grade pivot shift, generalised joint hypermobility, revision surgery or contact sport. It adds 20 to 30 minutes to the operation and around £3,000 to £5,000 to the cost. It is not needed for every patient.
-
How much does a private ACL reconstruction cost in the UK?
A primary ACLR with hamstring or quadriceps autograft runs £10,500 to £14,500 all-in, with BPTB at £11,500 to £16,500. LET augmentation adds £3,000 to £5,000, meniscus repair £2,500 to £4,500. Revision ACLR is £14,000 to £22,000. Most packages include one year of physiotherapy and criterion-based return-to-sport testing. We confirm a firm figure within one working day.
-
When can I go back to my sport?
Nine to twelve months is the norm for pivoting sport, not six. Returning under nine months roughly doubles the re-rupture rate. What matters is not the calendar but criterion-based testing: a limb symmetry index of 90% on hop tests, matched quadriceps and hamstring strength, a passing Y-balance test and an ACL-RSI psychological readiness score above 65. Straight-line running usually starts around three months; change-of-direction drills around six.
-
What are the chances of re-rupture or the other knee going?
Primary ACLR re-rupture runs at 3 to 6%, higher in the under-20s and in pivoting sports without LET augmentation. Contralateral ACL rupture is 3 to 8% over the following decade - your uninjured knee is now the highest-risk one you own. Meniscus status at surgery and rehab quality are the biggest levers. Around 85 to 90% of patients return to their pre-injury sport, though not always at the same level.
Ready to be matched?
Send us the MRI - we come back within one working day with two or three surgeon and graft options.
No sales call, no obligation, no fee to you.
Related pages
Looking for something else?
-
Meniscus repair
Repair rather than remove a torn meniscus.
Learn more -
MACI cartilage repair
Autologous chondrocyte implantation for focal cartilage defects.
Learn more -
Reverse shoulder replacement
For cuff-deficient shoulders and complex fractures.
Learn more -
Hip labral repair
Arthroscopic repair of the acetabular labrum.
Learn more -
ACL rupture
The condition guide - anatomy, diagnosis and decision to operate.
Learn more -
Meniscus tear
Bucket-handle, root and radial tears - and what to do about them.
Learn more