ACL injuries are a common and challenging setback for athletes and active individuals. Whether it’s a high school soccer player, a professional basketball star, or a weekend warrior, a torn ACL can cause significant instability and long-term knee issues. With advancements in surgical techniques and rehabilitation, ACL reconstruction has become a reliable solution for restoring knee function and mobility.

Understanding the ACL and Its Role in Knee Stability

The anterior cruciate ligament (ACL) is a key stabilizer of the knee, particularly for rotational movements. While not essential for simple walking, it is crucial for activities involving pivoting, cutting, or twisting—such as basketball, soccer, skiing, and martial arts. Without a functional ACL, the knee can become unstable, leading to further injuries and post-traumatic arthritis.

How Do ACL Injuries Occur?

ACL injuries are most common in athletes and active individuals. High school and college athletes face a higher risk due to the demands of sports like football, basketball, and soccer. Middle-aged individuals, or “weekend warriors,” often sustain ACL injuries through activities like skiing, jiu-jitsu, or pickleball. The majority of ACL injuries result from non-contact mechanisms—sudden twists, pivots, or awkward landings.

Symptoms and Diagnosis

A torn ACL is often associated with a “pop” sound, followed by pain, swelling, and difficulty bearing weight. Diagnosis begins with an X-ray to rule out fractures, followed by physical exams like the Lachman’s and pivot shift tests. An MRI confirms the tear and assesses additional knee damage.

When Is Surgery Necessary?

The need for ACL reconstruction depends on activity level rather than age. Young, active individuals—especially athletes—typically require surgery to prevent knee instability and further damage. Less active individuals may manage without surgery if they do not experience daily instability. If arthritis is present, ACL reconstruction may not be the best option, as it does not address underlying joint damage.

ACL Reconstruction Surgery

The torn ACL is replaced with new tissue, either from the patient (autograft) or a donor (allograft):

• Autografts (hamstring, patellar, or quadriceps tendon) are preferred for younger, highly active patients due to a lower failure rate.
• Allografts (cadaver tissue) are typically used for older, less active patients, offering a less painful recovery but a higher failure rate in younger athletes.

A tailored approach to graft selection ensures the best possible outcome based on age, activity level, and recovery goals.

Risks and Potential Complications

As with any surgery, ACL reconstruction carries risks, including infection, bleeding, and anesthesia-related complications. The most common issue is post-operative stiffness, highlighting the importance of physical therapy. Re-tearing is also a concern, particularly for younger athletes, where rates can be as high as 15-20%. Proper rehabilitation and adherence to post-surgical guidelines significantly reduce these risks.

The Challenge of ACL Recovery

ACL injuries impact athletes at all levels—from weekend warriors to professional stars. NCAA basketball standout Juju Watkins recently suffered an ACL tear, joining a long list of high-profile athletes facing this setback.

During my fellowship with Dr. James Andrews, I worked with elite athletes dedicating up to eight hours a day to rehabilitation. Even with that commitment, recovery can take 12 to 18 months. Klay Thompson, for instance, took nearly two years to return after ACL and Achilles injuries. Kyrie Irving is expected to miss the rest of the season due to his knee injury.

For non-professional athletes, patience and consistency are key. While most people lack access to full-time rehab, committing to a structured recovery plan is essential for regaining strength and mobility.

Why Choose Dr. Singhal for ACL Reconstruction?

With a special interest in sports, Dr. Singhal completed his fellowship training with the world-renowned Doctor James Andrews, which helped him master techniques in ACL reconstruction. Dr. Singhal prioritizes patient-specific treatment plans, ensuring optimal recovery and long-term knee stability. By utilizing advanced surgical techniques and personalized rehabilitation strategies, Dr. Singhal helps patients—from young athletes to active adults—regain confidence in their knee function and return to the activities they love. Book an appointment with Dr. Singhal today to start your journey toward recovery.