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this procedure repairs your knee after a tear of the anterior cruciate ligament commonly called the ACL this ligament is in the center of the knee it helps anchor the femur to the tibia this surgery can allow you to regain normal knee function in preparation for the procedure you are anesthetized the surgeon creates a small incision in the front of your knee this exposes the patellar tendon a thick band of tissue attached to your kneecap the surgeon removes a portion of this tendon and some bone where it is attached this tissue is called a graph it will be used to replace your damaged ACL next the surgeon creates a series of small openings in your skin an arthroscope is placed through one of the openings this is a viewing device that allows the surgeon to see inside your knee more surgical instruments are placed through the other openings the damaged ACL is removed using a guide pin the surgeon carefully drills the tunnel through the tibia and the femur The graft is pulled through this