ACL Reconstruction: 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 Reconstruction?
An orthopedic surgeon, a doctor who operates on bones and joints, performs ACL reconstruction. A physical therapist, a specialist in rehab exercises, helps you recover afterward. 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 reconstruction is surgery to rebuild the ligament in the center of your knee. The anterior cruciate ligament (ACL) connects your shin bone to your thigh bone. A tear can make your knee give way during activity, most often during side-step or cutting movements.
The torn ligament is replaced with new tissue called a graft. The graft comes from your own body or from a donor. A donor is a person who has died and chose to give all or part of their body to help others.
Why a doctor might recommend it
If a torn ACL is not rebuilt, your knee may stay unstable. That raises the chance of a meniscus tear, an injury to another part inside the knee. Reconstruction may be used for a knee that gives way, knee pain, not being able to return to sports, injury to other ligaments, or a torn meniscus.
How to prepare
Your care team will give you exact steps. Common ones include the following.
- Tell your provider about every medicine, supplement, and herb you take.
- You may be asked to stop medicines that make it harder for your blood to clot during the 2 weeks before surgery.
- Expect to be asked not to eat or drink for 6 to 12 hours before the procedure.
What happens during it
Most people have general anesthesia, which means you are asleep and feel no pain. The operation normally takes between 1 and 3 hours.
The surgeon usually uses knee arthroscopy. A tiny camera goes into the knee through a small cut, and other small cuts let the surgeon use other tools. The main steps follow.
- The torn ligament is removed.
- Tissue from your own body is called an autograft. It is often taken from the knee cap tendon, the quadriceps tendon, or the hamstring tendon. Donor tissue is called an allograft.
- The graft is placed where the old ACL was and attached to the bone with screws or other devices. As it heals, it becomes your new ligament.
- The cuts are closed with stitches.
Recovery
Most people can go home the day of the surgery. You may wear a knee brace and use crutches for 1 to 6 weeks.
Physical therapy can help you regain motion and strength. A full return to activities and sports often takes 4 to 6 months. Sports with quick changes in direction, such as soccer, basketball, and football, may need up to 9 to 12 months of rehab. Most people end up with a stable knee that does not give way.
Risks and side effects
Most people who have ACL surgery have no complications. Any anesthesia can cause allergic reactions to medicines and breathing problems. Bleeding and infection are risks of any surgery. Other risks include a blood clot in the leg, a ligament that does not heal, injury to a nearby blood vessel, knee pain, stiffness, and weakness of the knee. You may need more surgery if the graft tears.
Get urgent medical advice if, soon after surgery, you have throbbing or cramping leg pain, a high temperature, oozing or pus from the wound, or knee pain, swelling, or redness that is not getting better. These can be signs of an infection or a blood clot.
Call 911 or go to the emergency room if you have pain and swelling in your leg and you also have trouble breathing or chest pain. This could be a blood clot in the lungs, which needs treatment right away.
Who performs it
An orthopedic surgeon performs ACL reconstruction. Physical therapy afterward can help many people regain motion and strength in the knee.
Common questions
Do I stay in the hospital overnight after ACL reconstruction?
Most people can go home the day of the surgery. Your team will tell you what to expect.
How long does rehab take after ACL reconstruction?
Rehab often lasts 4 to 6 months.
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 go over the medicines, supplements, and herbs you take, which your surgical team needs to know about before surgery.
Sources
- MedlinePlus - ACL reconstruction
- NHS - How ACL (anterior cruciate ligament) surgery is done
- NHS - Complications of ACL (anterior cruciate ligament) surgery
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.
