ACL Tears and Reconstruction: What to Expect

December 16, 2022 | Andrew Staples, PA‑C
Man holding knee in pain

Medically Reviewed by Andrew Staples, PA-C

According to the American Academy of Orthopaedic Surgeons, knee injuries are among the most common reason to see an orthopedic surgeon.  While ACL injuries are seen throughout the year among a variety of athletes, they often occur in sports that involve cutting, pivoting, sudden stops, and jumping/landing, which can place too much stress on the ligament resulting in a tear. The sports with the highest rates of ACL injuries include: basketball, soccer, football, skiing, and ice hockey.

What is the anterior cruciate ligament?

The anterior cruciate ligament (ACL) is an important stabilizing structure of the knee. The ACL keeps the shin bone (tibia) from moving too far forward on your thigh bone (femur). It also prevents the knee from turning too far inward during twisting and pivoting motions. The ACL lives in the knee joint and its blood supply is normally injured when it is torn. This combination of factors keeps the ACL from being able to heal or regrow itself.

Symptoms of an ACL injury often include:

  • A popping sound
  • Severe pain
  • Rapid swelling
  • Loss of range of motion
  • Inability to put weight on the leg and remain stable

When to see a sports medicine specialist?

A visit to a sports medicine doctor is recommended anytime a serious knee injury occurs. Your physician will perform a physical examination and may obtain x-rays. In most cases, the physical examination will confirm an ACL tear. Usually, an MRI will be ordered to verify the tear, and to see if there has been any other damage to the knee. A brace and/or crutches may be provided if the doctor is concerned about falling or further damage to any of the knee structures.

Non-Surgical Treatment

Non-surgical treatment for ACL injuries is usually reserved for less active, older individuals, who desire a more sedentary lifestyle. Physical therapy can be used to regain most of the knee function and ice and medications can usually get the swelling to stop. Patients can often return to non-pivoting, activities such as jogging, cycling, and walking. For those who wish to pursue or resume activities that involve pivoting, cutting, jumping, or contact, non-surgical treatment is not recommended.

ACL Reconstructive Surgery

During ACL reconstruction surgery, the torn ligament is removed and replaced with a new ligament. The procedure is done arthroscopically, using small instruments to remove the torn ACL and replace it. This minimally invasive approach minimizes soft-tissue damage and improves recovery time.

In many cases, the graft tissue is taken from your own knee or hamstring. This is known as an autograft.  In select cases, your surgeon may recommend an allograft, where the graft is obtained from a donor. Normally autograft ACL reconstructions are performed on younger athletes and allograft tissue is used for older patients.  Your surgeon will talk to you about what treatment option is best for you.

What to Expect after Surgery?

The surgery typically takes 1-2 hours and you will be able to go home the same day. You will likely feel tired for several days following surgery. Your knee and the site of the incisions will be swollen. There may also be bruising around the site.

Often a brace and crutches are used for the first several weeks. Expect 2-4 weeks before you can put weight on your leg and then 2-9 months with a physical therapist building back strength and range of motion.  Physical therapy is usually started right away and is a very important part of the recovery process. Physical therapy will work on getting full range of motion and strength back in the knee. Your surgeon will see you at regular intervals throughout the recovery process and will work with your physical therapist to determine the ideal time to allow you to progress through the various stages of recovery.  Most patients are able to get back to performing all the sports and activities they did prior to the injury once fully recovered. While regular, day-to-day activities can often resume within 12 weeks, full recovery may take 6 months to a year.

Schedule an Appointment with Raleigh Orthopaedic

If you’re dealing with pain, discomfort, or an injury, don’t wait to get the care you need. Our expert team at Raleigh Orthopaedic is here to help you feel better, move better, and get back to doing what you love. Schedule an appointment online or call us at 919-781-5600 to be seen—often within 48 hours. For immediate care, we offer walk-in orthopedic urgent care services. Click here for hours and locations.

Disclaimer: The information on this site is for general informational purposes only and is not intended as medical advice. It should not be used as a substitute for professional diagnosis, treatment, or medical judgment. Always consult a physician or qualified healthcare provider with any questions you may have about a medical condition or treatment.

Andrew Staples, PA-C

Andrew Staples is a board-certified physician assistant. Andrew has been a PA with Raleigh Orthopaedic Clinic since 2020.