16 Ways to Get Your Best ACL Reconstruction Surgery Results

Photo: Cleveland Clinic Sports Medicine

A torn anterior cruciate ligament (ACL) used to end athletic careers and participation. Today, advances in ACL reconstruction surgery and rehabilitation enable most people who tear an ACL to return to their work and activities they enjoy.

Still, an ACL tear remains one of the most severe knee injuries. A torn ACL is painful. Immediately after your injury you’ll have difficultly walking normally, if at all.

A fully torn ACL cannot and does not heal on its own. Nearly everyone who wants to return to their sport or activities that require jumping, landing, cutting and pivoting will elect ACL reconstruction (ACLR) surgery.

Further down this page, you’ll find 16 steps you can take to improve the results of your ACLR.

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ACL Reconstruction Is Major Surgery

ACL reconstruction usually takes less than two hours and patients go home the same day. But it’s still considered major surgery. Read here to see why. 

  • You’re given general anesthesia. This means you’re unconscious for the procedure.
  • You’ll have pain, swelling and stiffness after the surgery. It can be two or three weeks before you walk without crutches.
  • If the replacement graft comes from your body (autograft), that area will also need to heal. Autografts are harvested from your patellar (knee) tendon, hamstring or quad.
  • Completing your rehabilitation program after surgery is the only way to return to full pre-tear activities, especially those involving pivoting, turning, twisting and jumping.
  • Expect full rehabilitation with return-to-sport training to take at least nine months.
  • Even with the most advanced ACL reconstruction, you can retear your ACL.

Read further on this page for how to improve your results from ACL reconstruction surgery.

Fully Torn ACLs Are Reconstructed

A fully torn ACL cannot be repaired reliably. The best practice is reconstruction.

In ACL reconstruction surgery, the surgeon drills one hole (called a tunnel) in your femur (thighbone) and another in your tibia (shin). A tendon from elsewhere in your body (autograft) or a cadaver (allograft) is inserted into the tunnels and fixed in place.

Modern ACL reconstruction surgery is done inside the knee using small devices inserted through the smallest possible slits. This disturbs nearby tissue and bone as little as possible, which aids recovery.

Even with these advances, surgery stresses your body. Other injuries in your knee may be treated at the same time, increasing what needs to heal.

Bypassing surgery is an option for those choosing to avoid competitive activities that stress the ACL, like pivoting and jumping.  

How Do I Achieve the Best ACL Reconstruction Results?

If your goal is to return to your pre-tear activities, you’ll want to get the best result from your ACL surgery. Read on for 16 things current research recommends.


Get evaluated as soon as possible after your injury by a physician, physical therapist or athletic trainer who knows ACL injuries.


Before surgery, control swelling, regain range of motion and build strength in your knee. See the prehabilitation phase of the widely used MOON Knee Group rehabilitation program.


Begin prehab exercises as soon as possible after your injury. You want your leg as strong and functional as possible before surgery. This gives you a better final outcome.


Work with a physical therapist or athletic trainer knowledgeable in ACL rehabilitation before and after your surgery.


If you have significant swelling right after your injury, discuss with your doctor having fluid aspirated (suctioned or drained) from your knee.


Choose the graft with the lowest retear risk for you. Use the MOON Knee retear risk calculators.


Follow and complete a post-surgery rehabilitation program as directed by your doctor, physical therapist and athletic trainer. You need strength, mobility and functional exercises to successfully return to normal activities—and particularly for return to sport.


Don’t try to get ahead. You could reinjure your ACL. Your rehab physical therapist, athletic trainer or doctor will determine when your knee is strong enough for the next phase.


Allow rest and recovery intervals after intense training. Stress followed by rest is how your body gets stronger.


Keep your follow-up sessions with your physical therapist and physician. Get evaluated if pain and swelling persist.


Learn your risk to tear your other ACL. Improve the strength and function of your injured and uninjured knee.


Follow a return-to-sport program for your activity.


Learn the correct ways to jump, land and cut. Share it with anyone who wants to avoid an ACL injury.


Maintain a healthy body mass index (BMI).


Wait to return to sport until your knee is ready. A reconstructed ACL has a higher retear risk. Returning too soon greatly increases that risk. Get your knee strong and functional first. Your rehabilitation team will use a set of tests to indicate your readiness.


Don’t smoke. Research shows smokers have worse ACL reconstruction outcomes.

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