ACL Reconstruction

ACL reconstruction is a surgical procedure that replaces a torn anterior cruciate ligament (ACL) with a tissue graft to restore knee stability. The surgery is performed arthroscopically (minimally invasive) and uses a graft from the patient's own tissue (autograft) or a donor (allograft). It is one of the most common sports medicine procedures, with over 200,000 performed annually in the US.

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Who Needs ACL Reconstruction?

ACL reconstruction is recommended for active individuals who want to return to pivoting sports (soccer, basketball, skiing), patients with persistent knee instability despite physical therapy, and young athletes. Some less active patients may manage with physical therapy and bracing alone.

What to Expect

MRI to confirm the tear and assess other structures (meniscus, cartilage)

Pre-operative physical therapy ("prehab") to reduce swelling and restore range of motion

Surgery takes 1-2 hours, performed arthroscopically under anesthesia

A tissue graft (patellar tendon, hamstring, or quadriceps tendon) replaces the torn ACL

Same-day discharge (outpatient procedure)

Crutches and a knee brace for the first 2-4 weeks

Recovery Timeline

Weeks 1-2

Rest, ice, elevation. Gentle range-of-motion exercises. Crutches for walking.

Weeks 3-6

Progressive weight-bearing. Begin physical therapy focused on quad activation and range of motion.

Months 2-3

Light jogging on even surfaces. Continued strengthening. Brace may be discontinued.

Months 4-6

Sport-specific training. Agility drills and cutting exercises begin.

Months 6-9

Gradual return to sport. Must pass functional testing (hop tests, strength tests).

Months 9-12

Full return to competitive sports for most patients.

Risks & Complications

Graft failure or re-tear (3-10%)
Infection (less than 1%)
Stiffness (arthrofibrosis)
Numbness around the incision
Graft site pain
Blood clots (rare)

Frequently Asked Questions

How long until I can play sports after ACL surgery?

Most athletes return to full sports participation 9-12 months after ACL reconstruction. Return timing depends on graft healing, strength recovery, and passing functional tests. Rushing back increases re-injury risk.

What graft is best for ACL reconstruction?

The most common grafts are patellar tendon (bone-tendon-bone), hamstring tendon, and quadriceps tendon. Each has trade-offs. Patellar tendon grafts have the lowest re-tear rate but may cause kneeling pain. Your surgeon will recommend the best option based on your activity level and anatomy.

Can an ACL grow back without surgery?

A completely torn ACL does not grow back on its own. The ligament cannot reattach to the bone. However, some patients, especially older or less active individuals, can function without an ACL by strengthening surrounding muscles. Surgery is recommended for those who want to return to high-demand activities.

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Estimated Cost

$20,000 - $50,000 (before insurance). Typically covered by insurance when medically necessary.

Full cost breakdown

Related Specialty

Sports Med Specialists →

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This information is for educational purposes only. Costs are estimates and vary by location, surgeon, and insurance. Always consult a qualified healthcare provider.