Consultant, Orthopaedics & Joint Replacement, Artemis Hospital, Gurgaon
Part 9 of 12 in Spectrum of Orthopaedic Disorder - Evaluation and Management
ACL and Ligament Reconstruction: Grafts and When Surgery Is Needed
September 6, 2026
A torn knee ligament changes how the joint moves: instead of tracking normally, the knee becomes loose and shifts forward and back with movement, the pattern Dr. Lamba described in one of his ligament injury cases.
Confirming the diagnosis with MRI
An MRI scan is used to assess the ligament itself and the surrounding structures, particularly the meniscus, the cartilage pad that acts as a shock absorber inside the joint.
Choosing between a patient's own graft and an artificial one
Where a single ligament needs reconstruction, Dr. Lamba prepares a graft from the patient's own body tissue to build the new ligament. Where two or three ligaments need reconstruction at once and there is not enough tissue available to harvest from the patient, he uses an artificial tendon graft material instead, built specifically for cases needing more than one ligament repaired.
This article is based on a Jivo Masterclass session conducted by Dr. Rohit Lamba, Consultant, Orthopaedics & Joint Replacement, Artemis Hospital, Gurgaon. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
This guide is based on a live Jivo Masterclass: Dr. Rohit Lamba taught doctors across Africa on April 6, 2025.
FROM THE LIVE Q&A
Moderator
Which group of patients is hip replacement surgery indicated for?
Dr. Rohit Lamba
Dr. Lamba outlined four categories. The first is congenital deformity, such as developmental dysplasia of the hip, where the hip is out of the socket from birth. The second is a childhood infection, Perthes disease, or a slipped epiphysis that reshapes the hip and leads to arthritis later in life. The third is avascular necrosis that has reached an advanced, arthritic stage in early adulthood. The fourth is a hip fracture that has not united properly, healing in a poor position that causes arthritis and pain.
Frequently Asked Questions
Is there a definitive treatment for arthritis?▼
Dr. Lamba answered on the assumption the question was about rheumatoid arthritis, since a network issue had cut off part of the question. In the early stage, before the cartilage is damaged, it can be managed well with disease-modifying antirheumatic drugs (DMARDs); cases that do not respond well can move to biological disease-modifying drugs, but only after full evaluation by an orthopaedic surgeon or rheumatologist. Once the cartilage is already damaged, the definitive treatment is hip replacement, and with current implants a patient can expect to stay pain-free and active for the next 30 to 35 years.
Which group of patients is hip replacement surgery indicated for?▼
Dr. Lamba outlined four categories. The first is congenital deformity, such as developmental dysplasia of the hip, where the hip is out of the socket from birth. The second is a childhood infection, Perthes disease, or a slipped epiphysis that reshapes the hip and leads to arthritis later in life. The third is avascular necrosis that has reached an advanced, arthritic stage in early adulthood. The fourth is a hip fracture that has not united properly, healing in a poor position that causes arthritis and pain.
What happens to the knee when a ligament tears?▼
The knee becomes loose and shifts forward and back with movement instead of tracking normally.
How is a ligament injury diagnosed?▼
An MRI scan assesses the ligament itself along with the meniscus, the cartilage pad that acts as a shock absorber inside the joint.
What is the difference between a patient's own graft and an artificial graft?▼
A single ligament reconstruction typically uses a graft prepared from the patient's own body tissue. When two or three ligaments need reconstruction and there is not enough tissue to harvest, an artificial tendon graft material is used instead.
In This Series: Spectrum of Orthopaedic Disorder - Evaluation and Management
- 1.Spectrum of Orthopaedic Disorders
- 2.Understanding the Main Causes of Knee Arthritis
- 3.How Robotic and Computer-Navigated Systems Are Used in Joint Replacement
- 4.Developmental Dysplasia of the Hip: Treating a Childhood Hip Problem
- 5.Perthes Disease: When Childhood Hip Damage Surfaces Years Later
- 6.Avascular Necrosis of the Hip: Causes, Stages and Treatment
- 7.Hip Replacement and Sickle Cell Disease: Why Blood Transfusion Comes First
- 8.When Is Hip Replacement the Right Treatment?
- 9.ACL and Ligament Reconstruction: Grafts and When Surgery Is Needed
- 10.Treating Fracture Non-Union and Bone Infection with External Fixators
- 11.Reconstructing Severe Trauma: Distraction Osteogenesis for Bone and Limb Loss
- 12.Vitamin D Deficiency in Children: When Rickets Requires Corrective Knee Surgery