Ayoosh Pareek, MDOrthopedic Sports Medicine 212-606-1493Book appointment
  1. Home
  2. Conditions
  3. Knee
  4. ACL reconstruction

ACL reconstruction

Whether you need surgery, what the operation involves, and how recovery goes, from Dr. Pareek's practice in New York and New Jersey.

Book an appointment 212-606-1493
Dr. Ayoosh Pareek

Do I need ACL surgery?

Not everyone does. In a randomized trial of young active adults, starting with structured rehabilitation and having surgery only if needed gave results similar to early surgery at two years (Frobell, 2010).

Surgery is more often discussed if your knee keeps giving way, if you play sports with cutting and pivoting, or if you also have a repairable meniscus tear. Age, sport, goals, and exam findings all matter, and the decision is one you make together with your surgeon.

What happens in ACL surgery?

A torn ACL usually can’t heal on its own, so the surgeon replaces it with a graft through small incisions, using a camera inside the knee. Any meniscus or cartilage damage found can be treated at the same time.

Choosing a graft

Common choices are your own patellar tendon, hamstring tendon, or quadriceps tendon, or donor tissue. Each has trade-offs that depend on your age, sport, and knee. Younger athletes are often steered toward their own tissue.

When the knee needs more

Revision surgery after a failed ACL reconstruction, or a knee with several torn ligaments, often needs a different plan. This might include a staged operation or added stabilizing procedures.

When can I return to sport?

Time and testing both matter. In one study of 106 pivoting-sport athletes, reinjury risk fell 51% for each month that return to sport was delayed, up to nine months after surgery. Beyond that, waiting longer showed no added benefit (Grindem, 2016).

Most people do get back to activity, but not all reach their old level. A review of 7,556 participants found that on average 81% returned to any sport, 65% to their preinjury level, and 55% to competitive sport (Ardern, 2014). Individual results vary.

Where can I be seen?

Dr. Pareek sees ACL patients at HSS in New York and at HSS in New Jersey. Bring any MRI images and reports you already have.

Already told you need surgery and want another view? Here’s how a second opinion works.

Sources

  1. Frobell RB, et al. A randomized trial of treatment for acute anterior cruciate ligament tears. N Engl J Med 2010;363:331-42.
  2. Grindem H, et al. Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction. Br J Sports Med 2016;50:804-8.
  3. Ardern CL, et al. Fifty-five per cent return to competitive sport following ACL reconstruction surgery. Br J Sports Med 2014;48:1543-52.

ACL recovery, week by week

Move the slider to any week after surgery. Timelines vary, and your own plan comes from your surgeon and therapist.

6

Walking
Focus
Daily life
  1. Weeks 0–2: Protect the kneeCrutches are common, and many patients wear a brace. Calm the swelling and get the knee fully straight. Desk work may be possible once pain settles.
  2. Weeks 3–6: Restore normal walkingMost patients come off crutches and walk without a limp. Regain bending and wake up the quadriceps. Driving depends on which knee it was and your pain.
  3. Weeks 7–12: Build strengthStairs and daily activity should feel more normal. Strength work, balance, and a stationary bike. Gym work under your therapist’s guidance.
  4. Weeks 13–24: Begin runningRunning starts only when strength and control allow it. Straight-line running, then early landing drills. Many patients feel normal here. The graft is still maturing.
  5. Weeks 25–39: Train for your sportCutting, pivoting, and sport-specific drills build up gradually. Close the strength gap between your two legs. Practice without contact, then limited contact.
  6. Weeks 40–52: Return to sportReturn follows testing, and rarely happens before nine months. Pass strength and hop tests, and feel ready to play. Keep your injury prevention work going long term.

Patient Stories. In their own words.

Read more reviews

Featured patient review

Dr. Ayoosh Pareek performed my son’s knee surgeries, and I am extremely grateful for the care he provided. Before coming to HSS, another hospital told us they were not willing to perform the surgery because my son’s case was complex—his knee ligaments were torn and he also had significant knee hyperextension. Wanting another opinion, I brought him to Dr. Pareek. He took the time to carefully evaluate my son and develop a clear surgical plan. His confidence, knowledge, and willingness to take on a difficult case gave us hope when we really needed it. The surgery was successful, and my son is now recovering remarkably well. I truly appreciate Dr. Pareek’s skill, professionalism, and dedication. As a parent, I felt my son was in the best possible hands, and I would highly recommend him to anyone needing an exceptional orthopedic surgeon.
Verified HSS patient review

Related conditions

Book an appointment with Dr. Pareek

In New York and New Jersey.

Book an appointment 212-606-1493
Book appointment 212-606-1493