The surgeon uses an arthroscope to look inside the knee joint without making any large incisions to actually open up the knee. After the arthroscopic examination, the remains of the torn ligament are usually cleared away.

Then, donor tissue is taken from a point near the knee to use as a replacement. Usually, a tendon just below the knee or along the inside edge of the knee is used. The surgeon prepares the donor tissue by shaping it and stitching it to get just the right amount of tension for its new use.

Using a special drill, the surgeon makes a tunnel through the shinbone (the tibia) in the lower leg. The donor tissue is passed through this tunnel and screwed or stapled in its new location. The knee is then tested by putting stress on the graft and making sure it is set at a tension that allows movement and relaxation of the joint.

The skin is closed. A dressing is applied to the wound, and a cold compress is placed around the knee to reduce swelling. Unless there are some unusual complications, patients go home the same day.