ACL Repair

What You Need to Know

If you or a loved one has been diagnosed with a torn ACL, it’s important to know your options for healing.

ACL stands for the anterior cruciate ligament. It’s a band of tissue inside your knee that gets damaged when it stretches or tears. If you have one, you know the pain it can cause. If someone in your family has one, you want the best care possible for relief and recovery. 

Causes of a torn ACL

ACL injuries are more common among athletes and people who play sports. The movements required in sports can put stress on the knee, such as:

  • Changing direction quickly (cutting)
  • Landing wrong after a jump
  • Planting your foot and pivoting
  • Stopping suddenly

When your ACL is healthy, it helps to hold together the bones of your knee. It also helps keep your knee stable. When it gets damaged, you can’t put pressure on your knee, making the simplest of movements painful and challenging.

You can also strain or slightly tear your ACL. When that happens, it can heal over time with the help of physical therapy. If it’s completely torn, you might need to have it replaced - especially if you’re young and active or an athlete who wants to keep playing sports. If you’re older or less active, your doctor might suggest non-surgical treatment options.

“ACL injuries are common in  people of all ages who like doing athletic activities, not just high school athletes,” according to Mark Lesh, MD, an orthopedic surgeon at the Adena Orthopedic and Spine Institute. “A torn ACL won’t heal correctly on its own. An ACL procedure provides the necessary reconstruction for stability to the knee.”

Signs of an ACL injury

Typically, you’ll hear a “pop” sound or have a sense your knee has given out, causing pain and instability.

After the injury, the knee can become swollen within a few minutes or a few hours. It may stay swollen for two to four weeks. When the swelling stops, it will still feel unsteady.

When this happens, apply ice for 20 minutes and lightly compress the injured area with an elastic bandage. Keeping your leg elevated can also help relieve pain.

Above all else, don’t play sports or do other activities until you have seen a doctor and know the severity of your injury.

Types of ACL procedures

The goal of any surgery is to get your knee stable and give it the full range of motion you had before the injury. With ACL reconstruction surgery, a doctor removes your torn ACL and replaces it with a tendon. Tendons connect muscle to bone. This is known as a graft. There are three types of grafts available with ACL surgery:

  • Autograft –Your doctor uses a tendon from somewhere else in your body, such as your other knee, hamstring or thigh.
  • Allograft – Your doctor uses tissue from someone else.
  • Synthetic graft – Your doctor uses artificial materials to replace the tendon.

Doctors typically use arthroscopic surgery on your ACL, inserting tiny tools and a camera through small cuts around your knee. This causes less scarring and faster recovery than open-knee surgery.

During the procedure, a surgeon will place the graft, then drill two holes (called tunnels) above and below your knee. They’ll place screws in the tunnels to hold the graft in place. This builds a bridge the new ligament can grow on as you heal.

Most people are able to go home on the same day of their surgery. Your doctor will have you stay off your leg, rest your knee and wear a brace to protect the joint.


As with any type of surgery, there are risks with ACL surgery. This can include:

  • A graft failing after you return to physical activity
  • A graft not healing well
  • Bleeding at the wound site
  • Blood clots
  • Breathing issues
  • Infection
  • Knee pain
  • Shock
  • Stiffness in your knee


Once you get home, you’ll keep your knee raised on pillows, put ice on it and wrap it in a bandage to keep it compressed. You may have to use crutches to keep the pressure off your knee.

Your doctor may recommend medication to help with pain, which may include over-the-counter medications like acetaminophen, ibuprofen, or naproxen. You may also receive prescription medication.

As your ACL starts to heal, you’ll start physical therapy to help strengthen the muscles and ligaments. Physical therapy is an important part of your recovery plan, as it helps you to walk and move around with confidence. After that, you should be back to normal activities within about nine months. For athletes, it can take up to 12 months to be able to play again.

You don’t have to live with pain

If you are dealing with knee pain or concerned you’ve injured your knee, talk to your doctor. Most ACL injuries can be diagnosed with a physical exam. An X-ray or MRI (magnetic resonance imaging) scan can be done to get a clear picture of the knee to see if there is a tear. Whether you play sports or play with your grandkids, there’s no reason to be sidelined with pain. Get the treatment you need to get back out there enjoying life again.

If you don’t have the procedure, you can’t participate in sports and activities you enjoy, which is good for your overall health and well-being,” says Dr. Lesh. “If you’re experiencing instability in your knee, delaying surgery can limit successful reconstruction and your return to the sport later.”