How much does it cost to repair an ACL?

Your anterior cruciate ligament (ACL) runs through the centre of your knee to connect your thigh bone (femur) to your shin bone (tibia).

ACL injuries occur when the leg twists or hyperextends under force. Abrupt changes in direction are a common cause of ACL injuries. Football, rugby and basketball are just some of the sports that place a high demand on the ACL with their cutting and sharp directional changes.

Any tearing or rupture (where the ligament severs in half) makes the knee unstable.

What does an ACL injury feel like?

You may hear or feel something pop and then feel sudden pain and weakness in your knee.

I think I injured my ACL. What do I do next?

The level of pain you feel will probably tell you whether you go straight to emergency hospital or head home to organise a physio or doctor appointment.

While ACL damage might be your first thought, the ACL is just one of four ligaments that supports the knee. Add to that potential damage to the meniscus that provides the cushion for the knee joint to function smoothly without bone-on-bone contact. Not to mention the surrounding muscles that can tear and bones that can suffer fractures and breaks. In short, self-diagnosis probably is not an option.

So, you will need some help. Here is your next choice: go to hospital or head home.

• Emergency department

The doctors at emergency will assess you and provide you with your next steps.

• Head home to plan your next move

Elevate your leg and keep it at a comfortable angle, perhaps with a pillow under your knee.

To ice or not to ice?

Many physios still advise applying ice to your injury straight away. Ice eases pain, swelling and discomfort, especially if applied in the shortly after the injury occurs. Pain and discomfort may be your biggest concerns early on in an injury, so it is well worth considering.

The doubt that has been rising is whether ice delays the healing process. Some studies show that ice may delay the natural healing process for ankle injuries. Just be aware that the standards for treating injuries may change in future as more evidence comes out.

What is an ACL repair?

An ACL repair (also called ACL reconstruction) is an operation that seeks to return your ACL to full function by adding a tendon graft from elsewhere your body and placing it to join your ACL.

Not all ACL injuries require surgery. Some people with ruptured ACLs may choose to not have them repaired if they give up sports with lots of directional changes. Your doctor will have more information specific to your situation.

GP or physio?

One of the advantages of visiting a GP first is that they can refer you to an MRI scan covered for free under Medicare while a physio cannot.

Once your doctor checks your results, you can see what damage has been done and whether surgical options are needed or worthwhile. From there your doctor can advise you if you’re ready for physio treatment.

Did you know? ACL repairs in Australia increased per head of population by 43% from 2000 to 2015, according to The Medical Journal of Australia. Australia has the highest rate of ACL repairs in the world.

Average private hospital cost in detail

About the data

• Based on an average across a number of episodes across the financial year 2016-2017 and 2017-2018.
• This is a representative cost and each procedure will be different.
• ACL Repair refers to MBS item numbers 49542 and 49539.
• All members had Gold Hospital cover. Their excess level is excluded from this analysis

As you can see from the above, the value of Access Gap is, on average, a saving of $3,820 in out-of-pocket costs. That is a dramatic difference.

The key tip is to ask your doctors to participate in Access Gap so that you get massive savings on your hospital treatment.

To find doctors with a track record of participating in Access Gap, use our Find a specialist search.

For a full explanation on what you need to do before going to hospital, read our Going to Hospital page.

Which cover provides benefits for ACL repair?

Gold Hospital* provides benefits towards:

• Hospital fees (accommodation and theatre fees). RBHS pays 100% of these fees.
• Doctor fees (such as for your anaesthetist and surgeon fees). RBHS pays a minimum of 25% of the Medicare Benefits Schedule fees towards anaesthetist fees.

If your anaesthetist participates in Access Gap, we pay them significantly more, reducing your out-of-pocket expenses in the process.

Before you go in for ACL repair, ask your doctors to participate in Access Gap to reduce your out-of-pocket expenses. Ask also for an itemised quote (called Informed Financial Consent in the Australian health system), this will show you what your out-of-pocket expenses.

*Waiting periods and excess payments may apply