Surgery is considered when it is the right choice for you. Before your operation you will receive a Preparing for Surgery booklet and a detailed guide related to your specific procedure.
Overview
The ACL is a ligament in the center of the knee that keeps the shinbone (tibia) from sliding forward on the thighbone (femur) and controls rotation. A torn ACL does not heal back together. Reconstruction replaces the ACL with a graft passed through tunnels drilled in the bone and fixed at both ends to restore knee stability.
- Surgery reliably restores stability. About 8 in 10 patients have a knee that tests normal or near-normal afterward.
- Returning to your previous level of sport is the most common outcome, but not guaranteed. About 8 in 10 return to sport, but only about 6 in 10 to their previous level.
- This is a 9-to-12-month commitment. We will be with you every step of the way.
Technique
- The procedure is done with arthroscopic assistance and an incision if graft harvest is needed.
- The torn ligament is removed and tunnels are drilled in the femur and tibia at the ACL's original attachment points.
- The graft is passed through the tunnels and fixed at both ends.
- Any meniscus or cartilage damage is addressed at the same time.
ACL reconstruction
Recovery
Getting Back to Activity
- Weeks 0-6Motion and quad control
- Weeks 6-12Walking and strengthening
- Months 3-5Running
- Months 5-9Cutting and agility
- Months 9-12Return to sport
Recovery Milestones
- Full extension: In the first 1 to 2 weeks.
- Desk work: Within 1 to 2 weeks.
- Walking normally: 6 to 12 weeks, out of the brace.
- Running: Around 12 weeks, once strength criteria are met.
- Physical work: 4 to 6 months.
- Cutting and pivoting sport: 9 months at the earliest.
Running, agility work and sport are based on strength and hop testing, not a date.
For how this condition is diagnosed and every treatment option, including nonoperative care, read the full ACL Injuries guide.
Instructions and therapy protocols
Each version of this operation has its own post-op instructions and physical therapy protocol. Bring the protocol to your first therapy visit.
- ACL ReconstructionPost-op instructionsPT protocol
- ACL Reconstruction with Meniscus RepairPost-op instructionsPT protocol
- ACL Reconstruction with Meniscus Root or Radial RepairPost-op instructionsPT protocol
- ACL Reconstruction with MCL Repair or ReconstructionPost-op instructionsPT protocol
Dr. Tummala's research on this topic
Arthroscopy · 2026Adding a Lateral Extra-articular Tenodesis to Quadriceps Autograft Anterior Cruciate Ligament Reconstruction Reduces Risk of Graft FailureRenfree SP, Tummala SV, et al.Am J Sports Med · 2024Hamstring Tendon Autograft Is Associated With Increased Knee Valgus Moment After Anterior Cruciate Ligament Reconstruction: A Biomechanical AnalysisTummala SV, et al.Orthop J Sports Med · 2025Association Between Autograft Choice and Psychological Readiness to Return to Sport After ACL ReconstructionBrinkman JC, Tummala SV, et al.Arthroscopy · 2022Mid-Term Outcomes of the All-Soft Quadriceps Tendon Autograft Are Noninferior to Hamstring Autograft in Primary Anterior Cruciate Ligament Reconstruction: Comparison With Minimum 5-Year Follow-UpBrinkman JC, Tummala SV, et al.Orthop J Sports Med · 2023ACL Reconstruction With Quadriceps Soft Tissue Autograft Versus Bone-Patellar Tendon-Bone Autograft in Cutting and Pivoting Athletes: Outcomes at Minimum 2-Year Follow-upRenfree SP, Tummala SV, et al.Orthop J Sports Med · 2025Outcomes of Multiply Revised ACL Reconstruction with Quadriceps Tendon Autograft plus Lateral Extra-articular Tenodesis in Competitive AthletesTummala SV, et al.
Show 13 more papers on this topic
Orthop J Sports Med · 2025The Role of Isolated Lateral Extra-Articular Tenodesis in Managing Residual Pivot Shift After Primary Anterior Cruciate Ligament Reconstruction and a New Medial Meniscal TearHoffer AJ, Tummala SV, et al.Arthroscopy · 2025Lateral Extra-Articular Tenodesis With Iliotibial Band in Anterior Cruciate Ligament Autograft Reconstruction for Female Soccer Athletes With Generalized Ligamentous Laxity Yields Graft Failure and Return-to-Sport Rates Comparable With Athletes Without Generalized LaxityParmar R, Tummala SV, et al.Am J Sports Med · 2022All-Soft Tissue Quadriceps Tendon Autograft in Revision Anterior Cruciate Ligament Reconstruction in Athletes: Comparison to Bone-Patellar Tendon-Bone Autograft With at Least a 2-Year Follow-upBrinkman JC, Tummala SV, et al.Arthroscopy · 2024Functional Return-to-Sport Testing Demonstrates Inconsistency in Predicting Short-Term Outcomes Following Anterior Cruciate Ligament Reconstruction: A Systematic ReviewGill VS, Tummala SV, et al.Arthroscopy · 2024Athletes Continue to Show Functional Performance Deficits at Return to Sport After Anterior Cruciate Ligament Reconstruction: A Systematic ReviewGill VS, Tummala SV, et al.Cureus · 2023Biomechanical Gender Differences in the Uninjured Extremity After Anterior Cruciate Ligament Reconstruction in Adolescent Athletes: A Retrospective Motion Analysis StudyVij N, Tummala SV, et al.Br J Sports Med · 2023Biomechanics and situational patterns associated with anterior cruciate ligament injuries in the National Basketball Association (NBA)Gill VS, Tummala SV, et al.Arthroscopy · 2024Prescription Testosterone Is Associated With an Increased Risk of Anterior Cruciate Ligament InjuryBrinkman JC, Tummala SV, et al.Am J Sports Med · 2025Association of Smokeless Tobacco Use With Perioperative Complications and Revision Surgery After Anterior Cruciate Ligament ReconstructionHolle AM, Tummala SV, et al.Arthroscopy · 2022There Is Substantial Variation in Rehabilitation Protocols Following Anterior Cruciate Ligament Reconstruction: A Survey of 46 American Orthopaedic SurgeonsGlattke KE, Tummala SV, et al.J Bone Joint Surg Am · 2021Anterior Cruciate Ligament Reconstruction Recovery and Rehabilitation: A Systematic ReviewGlattke KE, Tummala SV, et al.Orthop J Sports Med · 2026How Are We Matching in ACL Reconstruction Research? A Systematic Review of Methods, Reporting, and Covariate SelectionPatel JR, Tummala SV, et al.Arthrosc Sports Med Rehabil · 2024Patient Interest in Quadriceps Autograft Anterior Cruciate Ligament Reconstruction Is Increasing Over Other Autograft Options: A 12-Year Google Trends AnalysisBrinkman JC, Tummala SV, et al.
