How Much Does ACL Surgery Cost in India in 2024?

“Strength does not come from physical capacity. It comes from an indomitable will.” – Mahatma Gandhi. 

In the journey of overcoming knee injuries, especially ACL (Anterior Cruciate Ligament) tears, this quote resonates deeply. Understanding how to recover includes knowing the financial aspect, particularly the ACL surgery cost in India. 

For many, the question of “How much does ACL surgery cost in India?” stands as a significant consideration before getting on the road to rehabilitation. Hence, we have covered the post here to shed light on the financial dimensions or cost of ACL surgery in Noida, providing clarity and guidance to those navigating through their recovery journey.

What is ACL Surgery?

ACL surgery, or Anterior Cruciate Ligament surgery, is a procedure aimed at repairing or replacing the ACL, which is one of the key ligaments in your knee. The ACL connects the thigh bone (femur) to the shin bone (tibia) and is crucial for stabilizing the knee joint, especially in activities involving sudden stops, changes in direction, and jumps.

ACL injuries are common among athletes and individuals engaged in sports and physical activities, but they can also occur as a result of accidents or falls. 

When the ACL is torn or severely damaged, it can lead to knee instability, difficulty in movement, and the risk of developing osteoarthritis. 

Surgery is recommended when:

• The ACL injury is severe or complete.
• The knee remains unstable after physiotherapy or rehabilitation.
• The individual wants to return to sports or activities that require a stable knee.
• There are other injuries to the knee, such as damage to the cartilage, other ligaments, or meniscus.

Types of ACL Surgery Procedures

ACL surgery procedures are primarily aimed at reconstructing or repairing the torn ligament to restore stability and function to the knee. The choice of procedure largely depends on the individual’s age, activity level, the severity of the injury, and personal health considerations. 

Below is an overview of the different types of ACL surgery procedures:

1. Arthroscopic ACL Reconstruction

The most common procedure for treating ACL injuries, arthroscopic reconstruction involves making small incisions around the knee. A camera (arthroscope) and surgical tools are inserted through these incisions. 

The surgeon then replaces the torn ligament with a graft, which can be:

• Autograft: Tissue taken from another part of the patient’s body, such as the patellar tendon, hamstring tendon, or quadriceps tendon.

• Allograft: Tissue taken from a deceased donor.

This method is favored for its minimally invasive nature, which generally leads to quicker recovery times, less pain, and less scarring compared to open surgery.

2. Open ACL Reconstruction

Less commonly performed due to the advantages of arthroscopic techniques, open ACL reconstruction involves a larger incision and more direct access to the knee structures. This method might be chosen in complex cases or when additional knee issues need to be addressed simultaneously.

3. Double Bundle ACL Reconstruction

This technique aims to more closely replicate the knee’s natural anatomy by reconstructing both the anteromedial and posterolateral bundles of the ACL, rather than just one. 

The goal is to improve stability and control of the knee, particularly in rotational movements. It’s a more complex procedure and is often reserved for high-level athletes or individuals with specific anatomical considerations.

4. Revision ACL Reconstruction

This procedure is performed when a previous ACL reconstruction has failed or when the graft has been re-injured. Revision surgeries are more complex due to the presence of scar tissue, changes in bone structure from the initial surgery, and the need for a new graft. 

The choice of graft for revision surgery depends on what was used in the first surgery and the specific challenges of the case.

5. Bridge-Enhanced ACL Repair (BEAR)

A relatively new technique, BEAR, aims to stimulate healing of the torn ACL without replacing it with a graft. This involves using a special scaffold (bridge) placed between the torn ends of the ACL, which are then sutured together. 

The scaffold is soaked in the patient’s blood to encourage tissue growth and healing. Early research into BEAR is promising, especially for partial tears, but it’s still under investigation and not widely available.

Factors Affecting Cost of ACL Surgery in India

The cost of ACL surgery in India can vary widely based on several factors. Understanding these factors can help patients and their families plan financially for the procedure. 

Here’s an overview of the main elements that influence the ACL surgery cost:

1. Type of Hospital

• Private vs. Public: Private hospitals generally charge more than public hospitals due to the higher level of service and facilities offered.
• Tier of City: Hospitals in metro cities or Tier-1 cities often have higher rates than those in Tier-2 or Tier-3 cities, reflecting the overall cost of living and operational costs in different regions.

2. Type of Graft Used

Autografts vs. Allografts vs. Synthetic Grafts: The source of the graft material can significantly affect the cost. Autografts (tissue taken from the patient’s body) and allografts (donor tissue) have different costs associated with procurement and preparation. 

Synthetic grafts, although less commonly used, have a different cost structure altogether.

3. Surgeon’s Expertise and Reputation

The experience and reputation of the orthopedic surgeon can influence the cost. Highly reputed surgeons or those with specialized expertise in sports medicine may charge more for their services. 

For example, Dr Himanshu Gupta is a highly experienced orthopedic surgeon in Noida who holds expertise in ACL surgery and sports injury treatment. You can book your appointment for the best treatment at a reasonable cost.

4. Hospitalization Fees

The length of stay in the hospital can vary depending on the surgery’s complexity and the patient’s recovery speed. Longer stays incur higher costs, including room charges, nursing fees, and meals.

5. Surgical Technique and Equipment

The ACLT surgery cost in India can vary depending on whether the surgery is performed using traditional open surgery or arthroscopic techniques, which are minimally invasive and might involve more specialized equipment.

6. Anesthesia and Operating Room Charges

The fees for the anesthesiologist and the costs associated with using the operating room, including the surgical team and equipment, contribute to the overall cost of ACL surgery.

7. Medication and Post-Surgery Recovery Aids

The ACL surgery cost includes medications, knee braces, crutches, and other aids necessary for the recovery period.

8. Pre- and Post-Operative Care

Costs for pre-operative consultations, diagnostic tests (like MRI and X-rays), and post-operative follow-ups, physical therapy, and rehabilitation sessions can significantly add to the total expense.

9. Insurance Coverage

The extent of insurance coverage for ACL surgery can greatly affect the out-of-pocket expenses for the patient. Policies vary in terms of deductibles, co-pays, and the network of covered hospitals and surgeons.

10. Additional Treatments

If the ACL injury is accompanied by other knee injuries (such as meniscus tears or cartilage damage), addressing these issues during the surgery can increase the overall price of ACL surgery.

11. Geographic Location

The cost of living and healthcare expenses in different parts of India influence the cost of ACL surgery. Metropolitan areas and cities with higher living costs tend to have more expensive healthcare services.

12. Post-Surgery Rehabilitation

The duration and intensity of post-surgery rehabilitation and physical therapy needed also affect the total cost, depending on the facilities and professionals involved.

ACL Surgery Cost in India (Across Different Cities)

City	Average Cost of ACL Surgery (INR)
Delhi	₹1,50,000 – ₹3,00,000
Noida	₹1,10,000 – ₹2,80,000
Hyderabad	₹1,30,000 – ₹2,80,000
Jaipur	₹1,20,000 – ₹2,50,000
Bhubaneswar	₹1,10,000 – ₹2,90,000
Visakhapatnam	₹1,10,000 – ₹2,50,000
Indore	₹1,20,000 – 2,10,000
Nagpur	₹1,20,000 – ₹2,80,000
Aurangabad	₹1,10,000 – ₹2,70,000
Ahmedabad	₹1,20,000 – ₹2,90,000

Please Note:

• The costs represent a range to account for variations in hospital charges, surgeon fees, and other factors affecting the overall cost of ACL surgery in India.
• These figures are indicative and subject to change; actual costs can vary based on the specific details of each case, the choice of hospital and surgeon, the type of graft used, and other associated treatments.
• Costs outside of these procedures, such as pre-surgery consultations, diagnostic tests, post-surgery rehabilitation, and any unforeseen complications, are not included in this table and can significantly affect the total expense.

For the most accurate and up-to-date information, it’s crucial to consult directly with healthcare facilities or orthopedic surgeons in the respective cities.

Average ACL Surgery Cost in India According to Procedures

The average cost of ACL surgery can vary based on the surgical technique used. 

Type of ACL Surgery	Average Cost (INR)
Arthroscopic ACL Reconstruction	₹1,50,000 – ₹2,50,000
Double Bundle ACL Reconstruction	₹1,50,000 – ₹2,80,000
Revision ACL Reconstruction	₹2,00,000 – ₹3,50,000

Note:

• The costs listed above are indicative ranges intended to provide a rough estimate. Actual expenses may vary based on specific patient needs, the choice of hospital, the surgeon’s fee, the type of graft, and additional factors such as medication, post-operative care, and rehabilitation.

ACL Surgery Procedure

Here’s a step-by-step overview of the general ACL surgery procedure:

1. Preparation and Anesthesia

The patient is prepared for surgery, which includes administering anesthesia. The type of anesthesia can vary (general, spinal, or regional) depending on the specific case, patient preference, and anesthesiologist recommendation.

The knee area is cleaned and sterilized to prevent infection.

2. Diagnostic Arthroscopy (Optional)

Some surgeons may perform a diagnostic arthroscopy first, inserting a small camera through a tiny incision to examine the inside of the knee for any additional injuries to the cartilage or menisci that need to be addressed during the surgery.

3. Graft Harvesting (If Using Autograft)

If an autograft (tissue from the patient’s own body) is being used for the reconstruction, the surgeon will make an incision to harvest the graft. Common sources include the patellar tendon, hamstring tendon, or quadriceps tendon.

For an allograft (donor tissue), this step is skipped as the graft has been prepared beforehand.

4. Creating Bone Tunnels

The surgeon drills tunnels in the bones of the knee joint where the ACL attaches (the femur and tibia). These tunnels will hold the new graft in place, allowing it to function as the new ACL.

5. Graft Insertion

The graft is then threaded through the previously drilled tunnels. Its position is adjusted to replicate the natural angle and tension of the original ACL.

6. Securing the Graft

The graft is secured in place using screws, pins, or other fixation devices. These help to hold the graft while the bone grows into and integrates with it, a process that can take several months.

7. Final Assessment and Closure

The surgeon may perform another arthroscopic examination to ensure the graft is properly positioned and secured. They will then close the incisions with stitches or staples and cover the area with a sterile dressing.

In some cases, a knee brace may be applied to protect the graft post-surgery.

8. Recovery and Rehabilitation

Immediately after surgery, the focus is on reducing swelling, managing pain, and protecting the graft. Rehabilitation begins soon after to restore range of motion, followed by exercises to strengthen the knee and gradually return to normal activities.

A comprehensive rehab program is crucial for a successful recovery, often involving several months of physical therapy.

Benefits of ACL Surgery

Anterior Cruciate Ligament surgery offers several benefits, especially for individuals who have experienced a tear or severe damage to their ACL, which is crucial for knee stability and movement.

The primary benefits of ACL surgery include:

1. Restored Stability to the Knee

ACL surgery reconstructs or repairs the torn ligament, significantly improving the stability of the knee. This is crucial for performing daily activities, such as walking and climbing stairs, as well as for returning to sports or other physical activities that require rapid changes in direction.

2. Reduced Risk of Further Knee Damage

A stable knee reduces the risk of additional injuries to the menisci (knee cartilage) and other knee structures. Unrepaired ACL injuries can lead to recurrent knee instability, which can cause tears in the menisci and cartilage damage, potentially leading to early-onset osteoarthritis.

3. Return to Sports and Physical Activities

ACL surgery can enable athletes and active individuals to return to their pre-injury levels of sports and physical activities. Rehabilitation and physical therapy following surgery are tailored to help patients regain strength, flexibility, and confidence in their knee, aiming for a safe return to their desired activities.

4. Improved Quality of Life

By restoring knee function and reducing pain and instability, ACL surgery can significantly improve the quality of life. Patients often experience a return to a more active lifestyle, with improved ability to participate in recreational activities and maintain a healthy, active lifestyle.

5. Prevention of Knee Instability-Related Complications

Surgery helps prevent complications associated with chronic knee instability, such as recurrent injuries and the development of secondary knee problems. It also reduces the risk of developing degenerative knee conditions.

6. Customized Treatment

ACL surgery is highly individualized, allowing surgeons to choose the best type of graft and surgical technique based on the patient’s anatomy, activity level, and specific needs. This personalized approach helps optimize outcomes and recovery.

7. Comprehensive Rehabilitation Support

Post-surgery rehabilitation is a critical component of the recovery process, offering structured physical therapy to help patients regain knee function. This comprehensive approach ensures that patients not only recover from the surgery itself but also strengthen their knees to prevent future injuries.

Pre-Surgery Evaluation for ACL

Pre-surgery evaluation for ACL reconstruction is a critical phase that ensures the patient is a suitable candidate for the surgery and helps in planning the procedure for optimal outcomes. 

This evaluation involves several steps, including diagnostic tests, consultations with orthopedic surgeons, and specific preparations for the surgery. 

Diagnostic Tests Required

The pre-surgery evaluation usually begins with a thorough assessment of the knee to confirm the ACL injury and to check for any associated injuries to the knee structures, such as to the menisci, cartilage, or other ligaments.

• Physical Examination: The orthopedic surgeon will start with a physical exam of the knee to assess swelling, tenderness, range of motion, and stability. Specific maneuvers, such as the Lachman test, may be used to evaluate the integrity of the ACL.

• MRI (Magnetic Resonance Imaging): An MRI is typically ordered to visualize the extent of the ACL injury and to identify any other knee injuries. MRI provides detailed images of soft tissues, including ligaments, tendons, and cartilage.

• X-rays: Although X-rays do not show soft tissues like the ACL, they can reveal whether there are any associated bone fractures or signs of knee osteoarthritis.

• CT Scan: In some cases, a CT scan may be recommended to evaluate the bones and soft tissues of the knee more thoroughly, especially if there’s a suspicion of complex fractures.

Consultation with Orthopedic Surgeons

Consultation with an orthopedic surgeon specializing in sports medicine or knee injuries is essential for discussing the findings of the diagnostic tests, the suitability for ACL surgery, and the expected outcomes and potential risks.

• Discussion of Treatment Options: The surgeon will discuss the benefits and risks of ACL surgery versus non-surgical treatments based on the patient’s age, activity level, degree of knee instability, and personal goals.

• Choice of Graft: If surgery is chosen, the type of graft to be used for the ACL reconstruction—autograft, allograft, or synthetic graft—will be discussed. The surgeon will recommend the best option based on the patient’s specific situation and preferences.

• Understanding the Procedure: The surgeon will explain how the surgery is performed, what to expect during the recovery and rehabilitation process, and the timeline for returning to normal activities and sports.

How to Prepare for ACL Surgery?

Proper preparation can help reduce the risk of complications and improve the outcome of the surgery.

• Medical Evaluation: Patients may undergo a complete medical evaluation to assess their general health and identify any conditions that could complicate the surgery or anesthesia.

• Medications: The surgeon or anesthesiologist may advise on adjusting, stopping, or starting medications before surgery, especially blood thinners, anti-inflammatory medications, and supplements, to minimize bleeding risks.

• Pre-Surgery Rehabilitation: Prehabilitation or pre-surgery physical therapy may be recommended to strengthen the muscles around the knee and improve surgical outcomes.

• Arrangements for Recovery: Patients should plan for their post-surgery recovery, including arranging for help at home, preparing a comfortable recovery area, and ensuring accessibility to necessary items without the need to climb stairs frequently.

• Fasting Before Surgery: Typically, patients will be instructed to fast (not eat or drink) for a certain period before the surgery to prepare for anesthesia.

• Day of Surgery: Details about when to arrive at the hospital, what to bring, and what to wear will be provided. Loose-fitting clothes that can accommodate a knee brace or bandages post-surgery are advisable.

Potential Risks of ACL Surgery

While ACL surgery is a common and generally safe procedure aimed at restoring knee stability and function after an ACL injury, like all surgical procedures, it carries certain risks and potential complications:

1. Infection

As with any surgery, there is a risk of infection at the site of the incision or within the knee joint itself. Infections are typically treated with antibiotics, but severe cases may require further surgery to clean the area.

2. Bleeding and Blood Clots

There’s a risk of bleeding within the knee joint. Additionally, being immobile after surgery can increase the risk of developing blood clots in the legs (deep vein thrombosis, DVT). These clots can be serious if they travel to the lungs (pulmonary embolism, PE).

3. Graft Failure

The graft used to reconstruct the ACL may fail to integrate properly, or it may tear or stretch, leading to knee instability. This could occur due to a new injury or insufficient healing. Graft failure may necessitate additional surgery.

4. Limited Range of Motion

Some patients may experience stiffness in the knee or a limited range of motion after surgery. Physical therapy is crucial to help restore flexibility and function, but in some cases, further treatment or surgery may be required to address this issue.

5. Pain at the Graft Harvest Site

For autograft procedures, where the graft is taken from another part of the patient’s body (such as the patellar tendon, hamstring, or quadriceps), there can be pain, weakness, or discomfort at the donor site.

6. Nerve or Blood Vessel Damage

Although rare, the surgery can cause damage to nerves or blood vessels around the knee, leading to numbness, tingling, or circulatory problems.

7. Knee Instability or Worsening Symptoms

In some cases, the surgery may not fully restore stability to the knee, or patients may continue to experience symptoms such as pain or swelling. This could be due to a variety of factors, including technical aspects of the surgery or the body’s response to the procedure.

8. Arthrofibrosis

This condition involves excessive scar tissue formation inside the knee joint, leading to stiffness and limited movement. It may require physical therapy or additional surgery to remove the scar tissue.

9. Osteoarthritis

Having ACL surgery, especially if there has been previous damage to the knee joint, may not eliminate the risk of developing osteoarthritis in the knee in the future.

More Information on Cost of ACL Surgery

Torn ACL Surgery Cost in India

Generally, the average cost range for ACL tear surgery in India can be from approximately INR 80,000 to INR 2,50,000 or more.

Fiber Tape ACL Surgery Cost in India

Fiber tape is a newer technology used to reinforce ACL repairs or reconstructions, potentially offering enhanced stability and strength to the repaired ligament. The use of fiber tape in ACL surgery can be considered an adjunct to traditional ACL reconstruction techniques, aiming to improve the outcomes of the procedure.

The cost of ACL surgery with fiber tape in India could range from INR 1,00,000 to INR 2,50,000 or more. 

ACL Surgery Cost After Insurance

The cost of ACL surgery after insurance in India varies significantly based on several factors, including the specific insurance policy, the coverage details, the type of surgery performed, and the healthcare provider’s agreements with insurance companies. 

Insurance can significantly reduce out-of-pocket expenses for the patient, but the actual cost after insurance will depend on:

1. Insurance Policy Coverage

• Deductibles: The amount you need to pay out of pocket before your insurance starts to cover its share.
• Co-payments and Coinsurance: Your share of the costs of a covered healthcare service, calculated as a percent (coinsurance) or a fixed amount (co-pay).
• Out-of-Pocket Maximum: The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance, your health plan pays 100% of the costs of covered benefits.

2. Type of Surgery and Associated Costs

The overall cost can include the surgeon’s fees, hospital charges, anesthesia, the use of special surgical materials (like fiber tape), post-surgery rehabilitation, and any additional treatments required for complications or associated injuries (like meniscus or cartilage repair).

3. Network vs. Out-of-Network Providers

Insurance policies often have networks of preferred providers. Costs can be significantly lower when using in-network providers compared to out-of-network services, which may not be fully covered or could lead to higher out-of-pocket expenses.

4. Pre-authorization Requirements

Some insurance policies require pre-authorization for certain surgeries, including ACL reconstruction. Failure to get pre-authorization when required can result in higher costs for the patient.

5. Caps on Coverage

Some policies can have caps on how much they will pay for certain services or for the entire procedure, which could affect the final amount the patient needs to pay.

Given these variables, it’s crucial for patients to:

• Review their insurance policy carefully to understand what is covered and what their potential financial responsibility might be.
• Discuss with their healthcare provider about the expected costs and whether they are within the insurance network.
• Contact their insurance company directly to get detailed information on coverage, pre-authorization requirements, and any out-of-pocket costs based on the specifics of their ACL surgery.

ACL Arthroscopic Surgery Cost in India

The average cost for arthroscopic ACL surgery in India ranges from approximately INR 1,50,000 to INR 2,50,000.

FAQs About ACL Surgery in India