ACL Surgery
What Is ACL Reconstruction?
ACL reconstruction is the surgical treatment for a torn anterior cruciate ligament. Because a fully torn ACL has very limited ability to heal on its own, the surgery doesn’t repair the original ligament — instead, it replaces it with a new tissue graft that restores stability to the knee. This graft can be taken from the patient’s own body (an autograft, commonly from the quadriceps, hamstring, or patellar tendon) or from a donor (an allograft). Most surgeons favor an autograft for younger, active patients, since the body incorporates its own tissue more reliably, which lowers the risk of the graft re-tearing.
At Beyond the Scope Orthopaedics & Sports Medicine, we frequently use a portion of the patient’s own quadriceps tendon to reconstruct a torn ACL. Compared to a hamstring or patellar tendon graft, the quad tendon graft is larger and stronger, and it carries a lower risk of long-term pain at the site where the graft was taken — a complication that’s fairly common with patellar tendon grafts. ACL reconstruction is performed arthroscopically as an outpatient procedure, meaning patients go home the same day without an overnight hospital stay. Dr. Palsis is an experienced ACL surgeon who specializes in diagnosing and treating ACL injuries for patients in Brevard County, Florida.
When Is ACL Surgery Needed?
ACL surgery is generally recommended for patients who:
- Experience knee buckling or instability during daily activity or sports
- Wish to return to cutting, pivoting, or jumping sports
- Work physically demanding jobs that require a stable knee on uneven ground
- Have torn other knee ligaments in addition to the ACL
- Have completed physical therapy but continue to have episodes of the knee giving way
Not everyone with a torn ACL needs surgery — older or less active patients who are willing to modify their activities may do well with a structured nonsurgical rehabilitation program instead.
How Is ACL Reconstruction Performed?
ACL reconstruction is performed arthroscopically as an outpatient procedure, usually with a regional nerve block plus light general anesthesia. Through small incisions, the surgeon removes the torn remnants of the original ACL and prepares small tunnels in the femur and tibia at the exact locations where the native ligament attached. A tendon graft is then measured, passed through these tunnels, and secured with fixation devices, allowing it to gradually grow into the bone over the following months. The knee is moved through a full range of motion and tested for stability before the incisions are closed.
ACL Reconstruction vs. ACL Repair
Most ACL tears occur through the middle portion of the ligament, a location that doesn’t heal well even if stitched back together — which is why reconstruction with a graft is the standard of care for the majority of tears. However, in the small percentage of cases where the ACL tears away from its bony femoral attachment rather than through the middle (only about 1 in 20), an ACL repair — reattaching the ligament’s own tissue to the bone — may be an option for select patients. This preserves the patient’s original ligament rather than replacing it, though it isn’t appropriate for the majority of ACL tears.
Coast your way to recovery
Dr. Palsis utilizes innovative treatment techniques to get you back in motion and back to the life you love.
Recovery After ACL Surgery
ACL recovery follows a fairly predictable, structured timeline:
- Range-of-motion exercises begin immediately, with formal physical therapy starting within days
- Most patients are off crutches and have discontinued a knee brace by around 2 weeks
- Full range of motion is typically regained by 6 to 12 weeks
- Stationary biking is often possible within the first 1 to 2 weeks; outdoor cycling by around 3 months
- Jogging and lower-impact sports are usually introduced around 4 months
- Return to full cutting and pivoting sports typically isn’t cleared until 8 months or later, once strength testing confirms the knee is ready
Consistent physical therapy attendance is one of the strongest predictors of a successful outcome after ACL surgery.
Get back to what moves you
Dr. Palsis specializes in the treatment of knee, shoulder, and sports injuries.