Cruciate ligament · Knee surgery · Vienna
A torn anterior cruciate ligament (ACL) is not an emergency – but it is a decision worth taking calmly and getting right. As an English-speaking knee specialist in Vienna, I assess whether surgery is needed at all, treat conservatively and support you with an honest second opinion. If an ACL reconstruction is required, I organise the operation for you – and stay at your side for your questions.
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The anterior cruciate ligament (ACL) is the central stabiliser of the knee. It stops the shin bone from sliding forward and controls rotation – exactly the movements involved in football, skiing, basketball and tennis. When it tears, the knee loses its rotational control.
A torn ACL is often part of an "unhappy triad" – ligament, meniscus and inner ligament injured together. That is why a thorough assessment of the whole knee matters, not just the cruciate ligament itself.
An audible "pop" at the moment of a twisting injury
Rapid swelling within a few hours (blood in the joint)
Instability – the knee "gives way", especially when turning
Confirmed with the Lachman and pivot-shift tests and an MRI
A torn ACL does not always mean an operation – but leaving an unstable knee untreated risks further damage to meniscus and cartilage. The decision depends on you.
For young, active patients, those in pivoting sports, physically demanding jobs, and any knee that repeatedly gives way – to restore stability and protect the joint.
For older or less active patients whose knee stays stable in daily life, with a strong, well-trained muscular envelope – provided there is no meniscus damage requiring surgery.
The torn ligament cannot simply be sewn back together – it is replaced with one of your own tendons. Each option has trade-offs, and the right one depends on your sport and anatomy.
This highly specialised operation I do not perform myself — but if it is indicated, I am glad to organise it for you and to talk you through the options beforehand.
The most common choice: reliable, small incision, little pain. Slightly slower to mature.
Strong and versatile, with little donor-site pain – an increasingly popular option.
Very robust, favoured by some elite athletes – but can cause pain when kneeling.
Rehab is where an ACL reconstruction succeeds or fails. Return is guided by strength and stability tests, not by the calendar – rushing back is the main cause of re-rupture.
Office work is often possible again within about 1–2 weeks, physically demanding jobs considerably later. Crutches are used for the first weeks.
Straight-line running from a few months; pivoting and contact sports realistically around 9–12 months, once objective criteria are met.
Surgery and hospital stay generally covered in full
Direct billing – no upfront payment
Surgery date usually within 1–2 weeks
Transparent cost estimate before the procedure
Surgery as a self-payer possible at any time
Practice visits: approx. 80% reimbursement of the statutory tariff
A twisting injury with an audible pop, rapid swelling within a few hours and a feeling of instability strongly suggests a torn anterior cruciate ligament. But not every swollen knee means a ligament tear – the meniscus or joint capsule can also be injured. Have a freshly injured, swollen knee examined promptly: the diagnosis is confirmed with clinical tests (e.g. the Lachman test) and an MRI.
Not always. Older or less active patients with a stable knee in daily life can sometimes do well with targeted muscle training. Younger, active patients, those doing pivoting sports, and knees that keep giving way usually benefit from reconstruction – both to restore stability and to protect the meniscus and cartilage from further damage.
There is no single best graft – it depends on you. The hamstring tendon is the most common and reliable choice; the quadriceps tendon is strong with little donor-site pain; the patellar tendon is very robust and favoured by some high-level athletes but can cause kneeling pain. Which graft suits you best – based on your sport, profession and anatomy – is something we discuss together in advance.
A realistic return to pivoting sports is around 9–12 months, not just 6. The graft needs time to mature and the muscles to regain full control. Return is guided by objective criteria – strength and stability tests – not by the calendar alone. Rushing back is the main cause of re-rupture.
Usually not immediately. A very swollen, stiff knee is first calmed down with physiotherapy to restore range of motion – operating on an irritated knee increases the risk of stiffness. The reconstruction is then performed under good conditions, typically a few weeks after the injury. Locked knees or combined injuries may need earlier surgery.
With supplementary (Sonderklasse) insurance the costs of the operation and hospital stay are generally covered in full, with direct billing and no upfront payment. Surgery dates at Vienna's private hospitals are usually available within 1–2 weeks. I am happy to provide a cost estimate in advance.
A second opinion gives you clarity on whether reconstruction is right for your knee, your sport and your goals – and which graft would suit you.
Tell me about your injury and your goals – I take the time for a thorough assessment and an honest plan, in English, without pressure.
1040 Vienna: +43 1 585 62 60 · 1020 Vienna: +43 1 890 45 20
By prior appointment only · 1040 Vienna-Wieden (Große Neugasse 28/2) · 1020 Vienna-Leopoldstadt (Vorgartenstrasse 206c)