ACL Surgery: What It Is and What to Expect
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor provides ACL Surgery?
ACL surgery is done by an orthopedic surgeon, a doctor who treats bone and joint problems. A physical therapist, a rehab specialist, helps with recovery. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What it is
ACL surgery is an operation on a knee with a torn anterior cruciate ligament, or ACL. The ACL runs diagonally in the middle of the knee. It keeps the shin bone from sliding out in front of the thigh bone and helps keep the knee steady when it twists.
Surgery can be a repair or a reconstruction. Reconstruction is the most common. It replaces the ligament with tissue from your own body or from a donor. Repair is usually kept for tears close to where the ligament attaches to bone and for partial tears that cause symptoms.
Why a doctor might recommend it
Not everyone with a torn ACL needs surgery. The choice depends on how bad the injury is, your age, how much wear and tear your joint has, whether your knee feels unstable, and how active you are.
Care without surgery is always an option. It includes medicines to calm swelling and physical therapy to rebuild strength and confidence in the knee. The swelling and pain may go away on their own, but returning to normal activities often makes the knee feel less stable and risks more damage inside the knee.
How to prepare
The decision starts with a talk with your orthopedic surgeon about your goals, your options, and your recovery plan. Other steps may include the following.
- Have an exam. Your doctor compares the hurt knee with your other knee.
- Get an MRI scan, which gives the best view of the ligaments and cartilage.
- Try to stop smoking, since smoking can slow wound and bone healing.
- If you have diabetes or heart disease, you may be asked to see the provider who treats it.
What happens during it
General anesthesia is the usual choice, so you sleep through the operation. The surgeon works through small cuts, with a tiny camera placed in the knee, which is called arthroscopy. Any other damage found in the knee is fixed as well. Once the new ligament is fixed to the bone, it slowly remodels as it heals and becomes your new ACL.
Recovery
Recovery may take several months or longer, depending on your age and general health. You will usually do most activities again within a few months. Playing sport can take up to a year.
Most people leave the hospital the same day. A physical therapist teaches you home exercises, and you may get crutches and a knee brace at first. A follow-up visit comes about 2 to 3 weeks after surgery, and you will have regular physical therapy for a few months. Helpful tips include the following.
- Keep your leg raised when you rest, and do not put a pillow under your knee.
- Walk around as advised to help prevent blood clots.
- Do not drive until your medical team says you are fit to drive.
- Most people return to work after about 4 to 6 weeks, depending on the job.
Risks and side effects
The risks from anesthesia include allergic reactions to medicines and breathing problems. Bleeding and infection are risks of any operation. Other risks include a blood clot in the leg, the ligament not healing, and stiffness or weakness in the knee.
Call 911 or go to the emergency room if you have chest pain lasting two minutes or more, trouble breathing, or bleeding that will not stop.
Who performs it
An orthopedic surgeon performs ACL surgery. A physical therapist leads your rehab afterward.
Common questions
Does everyone with a torn ACL need surgery?
No, not everyone with a torn ACL needs surgery. Care without surgery is always an option. Your surgeon can help you choose based on your injury, age, and activity level.
What is the difference between ACL repair and ACL reconstruction?
Repair is usually used for tears close to where the ligament attaches to bone and for partial tears that cause symptoms. Reconstruction replaces the ligament with a graft and is the most common surgery.
How does a direct primary care or concierge doctor fit in?
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either one can talk with you about the things that shape the choice to have surgery, such as how bad the injury is, your age, and how active you are.
Sources
- American Academy of Orthopaedic Surgeons - OrthoInfo - Anterior Cruciate Ligament (ACL) Injuries
- NHS - Recovering from ACL (anterior cruciate ligament) surgery
- MedlinePlus - ACL reconstruction
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
