ACL Repair vs. ACL Reconstruction: What’s the Best Option for You?
Understanding the Difference Between ACL Repair and ACL Reconstruction
An ACL injury can be a major setback for any athlete or active individual. When it comes to treatment, ACL reconstruction has long been the gold standard. However, advances in surgical techniques have made ACL repair a viable option in certain cases.
Both procedures aim to restore knee stability, but they take different approaches, have different recovery timelines, and offer unique benefits. Choosing the right option depends on the specifics of your injury, your activity level, and your long-term goals.
What’s the Difference?
ACL Repair: Preserving the Native Ligament
ACL repair is a less invasive procedure that involves reattaching the torn ACL to the bone rather than replacing it with a graft. This option is only possible in cases where the ACL has torn at its attachment point rather than being completely ruptured in the middle.
This technique preserves the original ligament structure and function, potentially leading to a quicker recovery. Because no graft is required, ACL repair also eliminates risks associated with graft harvesting, such as pain at the donor site. However, ACL repair is not suitable for all tears, and there is a higher risk of re-tearing compared to reconstruction.
ACL Reconstruction: Replacing the Ligament
ACL reconstruction remains the most widely used surgical option, particularly for athletes who want a long-term solution. In this procedure, the torn ACL is removed and replaced with a graft from the patient’s own patellar tendon, hamstring tendon, or quadriceps tendon, or in some cases, a cadaver graft.
ACL reconstruction provides a more predictable outcome, especially for patients involved in high-demand sports that require cutting, pivoting, and rapid changes in direction. While the recovery period is slightly longer than ACL repair, reconstruction has a lower re-tear rate and is often the better choice for patients who want to return to competitive sports.
Which Option Is Right for You?
ACL Repair May Be the Right Choice If:
Your ACL tear is near the femoral attachment, and the ligament is still largely intact.
You are younger and highly active, as preserving the native ligament may offer better long-term knee function.
You want to avoid graft-related complications, such as pain at the donor site.
Your knee has no additional injuries, such as meniscus tears or cartilage damage.
Despite these benefits, ACL repair has a higher risk of re-injury, particularly for young athletes.
ACL Reconstruction May Be the Right Choice If:
Your ACL is completely torn or severely damaged.
You play high-impact sports that require cutting and pivoting, such as soccer, basketball, or skiing.
You have hypermobile joints or a history of knee instability.
You have had previous ACL injuries or chronic knee instability.
ACL reconstruction remains the most reliable option for long-term knee stability, especially for athletes who need to trust their knee under high-stress conditions.
Recovery and Return to Sport
Both ACL repair and ACL reconstruction require extensive rehabilitation, but there are differences in recovery timelines.
ACL repair generally allows for a quicker return to daily activities, with many patients resuming light exercise within a few months. However, because the native ACL is being preserved, healing is less predictable, and some patients may still require reconstruction later.
ACL reconstruction requires a longer recovery but provides more consistent results. The rehabilitation process focuses on restoring strength, mobility, and neuromuscular control, with a typical return to sport around nine to twelve months after surgery.
For both procedures, the success of recovery depends on a structured physical therapy program and adherence to rehabilitation protocols.
The Verdict: ACL Repair vs. Reconstruction?
Both procedures have their place in modern sports medicine. ACL repair offers a less invasive option for select cases but comes with a higher risk of re-injury. ACL reconstruction remains the standard choice for most patients, particularly athletes who want a durable and predictable return to high-demand activities.
At Vail-Summit Orthopaedics & Neurosurgery, Dr. William Sterett provides individualized treatment plans to help athletes and active individuals get back to doing what they love. If you have an ACL injury and want to discuss the best approach for your recovery, schedule a consultation today.
