This is The Mayo Clinic's description of the ACL reconstruction procedure:
ACL surgery is usually done with arthroscopic techniques. An orthopedic surgeon specializing in bone, muscle and joint surgery performs the procedure. During the procedure, the surgeon disinfects the area around the knee and applies sterile drapes to further prevent infection. He or she may use a pressure band (tourniquet) to decrease blood loss and to see the knee better. The surgeon makes a small incision on the knee and inserts the arthroscope — a thin instrument equipped with a small camera. The knee is filled with saline solution to provide a better view. A light and a small video camera with a magnifying lens are attached to the arthroscope and connected to a monitor so that the surgeon can see the magnified image of the knee.Here is a webcast of an arthroscopic ACL reconstuction. Lara got to be in the operating room, but this takes you right inside the knee.
If you're having an autograft, the graft will be taken from your chosen tendon. A hole is drilled at an angle through the tibia and into the femur, following the path of the injured ACL. The graft is then threaded through the holes, and the small pieces of bone at each end of the tendon are attached to the femur and the tibia, usually with screws, which are left in place permanently. The entire procedure takes about two hours.
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