ACL Injury FAQs

Dr. Ronak Patel, a double board-certified orthopaedic surgeon serving the Chicagoland area, answers the most common questions patients have about ACL injuries and treatment options.

What Is the ACL and What Does It Do?

The anterior cruciate ligament (ACL) is one of four major ligaments in the knee. It runs diagonally through the center of the joint and prevents the tibia (shinbone) from sliding forward relative to the femur (thighbone). It also helps control rotational stability during activities like cutting, pivoting, and landing from a jump.

How Do I Know If I Tore My ACL?

Most patients report hearing or feeling a “pop” at the time of injury, followed by rapid swelling within the first few hours. Other signs include a feeling of instability or the knee “giving way,” difficulty bearing weight, and loss of range of motion. An exam with Dr. Patel will typically indicate any ligamentous laxity.  An MRI is the most reliable imaging study to confirm an ACL tear, and Dr. Patel offers same-day MRI at our Chicagoland offices to expedite diagnosis.

Can I Walk on a Torn ACL?

Many patients can walk on a torn ACL once the initial swelling subsides, but this does not mean the knee is stable. Walking on flat surfaces may feel manageable, but the knee may buckle or give way during cutting, pivoting, or uneven terrain. Walking without a functional ACL also increases the risk of further cartilage and meniscus damage over time.

Do All ACL Tears Require Surgery?

Not all ACL tears require surgery. The decision depends on your age, activity level, degree of instability, associated injuries, and personal goals. Younger, active patients and athletes who participate in cutting or pivoting sports typically benefit from surgical reconstruction. Some older, less active patients may manage well with physical therapy and activity modification, particularly if the knee does not exhibit significant instability.

What Are My Surgical Options for an ACL Tear?

There are several approaches, and Dr. Patel individualizes the recommendation for each patient:

• ACL Reconstruction: The torn ligament is replaced with a graft. Graft options include patellar tendon autograft, hamstring tendon autograft, quadriceps tendon autograft, and allograft (donor tissue). Ωxz
• ACL Repair with BEAR Implant: For eligible patients with acute tears (within 50 days) and an intact tibial stump, the BEAR procedure uses a collagen scaffold and the patient’s own blood to facilitate natural ACL healing. Two-year Bridge Registry data presented at AOSSM 2025 showed a retear rate of 5%.
• Non-surgical management: Physical therapy, bracing, and activity modification for selected patients with lower functional demands.

What Type of Graft Is Best for ACL Reconstruction?

There is no single “best” graft for all patients. The choice depends on individual factors:

• Patellar tendon (bone-patellar tendon-bone): Often considered the gold standard for young athletes in high-demand sports. Offers bone-to-bone healing but has a higher incidence of kneeling discomfort.
• Hamstring tendon: Lower risk of anterior knee pain but some studies show slightly higher revision rates in certain populations compared to patellar tendon.
• Quadriceps tendon: A 2024 editorial in Arthroscopy described it as having favorable biomechanical properties and lower donor-site morbidity than patellar tendon. It is increasingly used for both primary and revision ACL reconstruction.
• Allograft: Avoids donor-site morbidity but has higher failure rates in younger, highly active patients. Typically reserved for lower-demand patients or revision settings.

How Long Does ACL Surgery Take?

ACL reconstruction is typically performed arthroscopically and takes under an hour, depending on the complexity. If additional procedures are needed, such as meniscus repair or cartilage treatment, the surgery may take longer. Most patients go home the same day.

What Does ACL Surgery Recovery Look Like?

Recovery typically follows these general milestones, though individual progress varies:

• Weeks 1–2: Crutch-assisted walking, early range-of-motion exercises, quadriceps activation, and icing for swelling.
• Weeks 2–6: Progressive weight-bearing, stationary cycling, and gentle strengthening. Most patients can return to desk work within 1 to 2 weeks.
• Months 2–4: Focused strengthening of the quadriceps, hamstrings, and hip muscles. Light jogging may begin around 3 to 4 months if milestones are met.
• Months 4–6: Progressive sport-specific drills, agility work, and plyometrics.
• Months 6–9+: Criteria-based return-to-sport testing. Research consistently shows that delaying return to full sport until at least 9 months reduces re-injury risk.

When Can I Drive After ACL Surgery?

If surgery was on the left knee and you drive an automatic vehicle, you may be able to drive within 1 week, as long as you are off narcotic pain medication. For right knee surgery, most patients return to driving at 2 to 6 weeks, once they have adequate quad control and can perform an emergency stop safely.

What Happens If I Don’t Get ACL Surgery?

Living with an ACL-deficient knee increases the risk of recurrent episodes of instability, which can cause progressive damage to the menisci and articular cartilage. Over time, this cumulative damage significantly raises the risk of developing early-onset osteoarthritis. For patients who experience instability symptoms, surgical reconstruction is generally recommended to protect the knee long-term.

How Much Does ACL Surgery Cost in Illinois, Indiana or Wisconsin?

The cost of ACL reconstruction varies depending on the facility, graft type, and whether additional procedures (like meniscus repair) are needed. Fortunately, a majority of health insurance plans in Illinois, Indiana and Wisconsin cover ACL reconstruction when it is deemed medically necessary. Our staff can help verify your insurance coverage and discuss any out-of-pocket costs before your procedure.