ACL reconstruction

An ACL tear can sideline you from the sports and activities you love, but ACL reconstruction can help restore your knee's stability and function. Novant Health orthopedic sports medicine specialists offer advanced ACL reconstruction surgery and personalized care to guide you through every step of recovery, from diagnosis to returning to activity.

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What is ACL reconstruction?

ACL reconstruction is a surgical procedure that replaces a torn anterior cruciate ligament, or ACL, with a graft. The graft may come from another part of your own body, called an autograft, or from a donor, known as an allograft.

The goal of ACL reconstruction surgery is to restore knee stability so you can return to normal activities, including sports. Many procedures use arthroscopic techniques, which rely on small incisions and a camera to help your surgeon view and repair the knee with precision. This approach is often associated with a lower risk of infection and a smoother recovery compared to traditional open surgery.

Most ACL reconstruction procedures are done on an outpatient basis, meaning you can typically go home the same day. Afterward, your care team will guide you through a structured rehabilitation plan built around your goals.

A medical illustration of a knee joint with an ACL tear.

See what happens during an ACL reconstruction

Learn how ACL reconstruction surgery is done, what to expect before and after and how it helps you get back to the activities you enjoy.

Videos in our patient education library are available to help you gain a general understanding of the condition or procedure. Read disclaimer.

Common reasons for ACL reconstruction

You may need ACL surgery in the following situations:

Complete ACL tears: A fully torn ligament cannot heal on its own and often requires surgical reconstruction.
Active individuals and athletes: If you need a stable knee for sports or physical activity, surgery is often the best option to restore function.
Non-surgical treatment that hasn't worked: When rest, bracing or physical therapy don't provide enough stability or relief, ACL reconstruction may be recommended.

Treatment options (surgical and nonsurgical)

Your care team will recommend an approach based on the severity of your injury, your activity level and your goals.

Nonsurgical management: Physical therapy, bracing and activity modification may help patients with partial tears or lower activity demands avoid surgery.
Arthroscopic ACL reconstruction: A minimally invasive technique using small incisions to replace the torn ligament with a graft, which may support a faster recovery and lower infection risk than open surgery.
Autograft reconstruction: Uses tissue from another part of your own body to rebuild the ligament.
Allograft reconstruction: Uses donor tissue to rebuild the ligament, which may be an option depending on your situation.

Recovery and rehabilitation

Recovery from ACL reconstruction is a gradual process that typically takes several months and is guided by your rehabilitation team.

Early phase (weeks 1 to 6): Focus is on reducing swelling, managing pain and protecting the healing graft. You may use crutches and limit weight-bearing while starting gentle range-of-motion exercises.
Rehabilitation phase (weeks 6 to 12): Therapy shifts toward strengthening the quadriceps and hamstrings, along with improving flexibility, balance and coordination as weight-bearing activity gradually increases.
Return to activity: Most patients can safely return to normal activities, including sports, within 6 to 12 months, depending on healing progress and functional testing by your care team.

Your specialists will also share personalized strategies to help reduce the risk of re-injury, such as strengthening exercises, balance training, proper footwear and gradually increasing training intensity.

Risks and considerations

As with any surgery, ACL reconstruction carries some risks, including infection, stiffness, graft failure or continued knee instability. Every patient heals differently, and your care team will review your individual risk factors before moving forward with treatment.

Your orthopedic sports medicine specialist will walk you through what to expect, answer your questions and help you feel confident in your treatment plan before and after surgery.

Conditions we treat

Our expert team delivers expert care for a wide range of sports and activity-related injuries and conditions.

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Why treatment is important

Leaving an ACL tear untreated can affect your knee's stability and limit your ability to stay active. ACL reconstruction can help you regain strength, confidence and function so you can return to the activities you enjoy. With the right care team by your side, recovery is a partnership focused on getting you back to your normal life.