What is acl reconstruction.
The anterior cruciate ligament (ACL) stabilizes the knee against rotational force. When it tears, the knee feels untrustworthy on a cut, a pivot, or sometimes a stair. Most patients need surgery to return to cutting or pivoting sports; some can manage non-operatively.
ACL reconstruction replaces the torn ligament with a graft — usually the patient's own patellar tendon, hamstring, or quadriceps tendon — placed precisely in the original ligament's footprint through small arthroscopic incisions.
Who it's for.
- Athletes wanting to return to cutting or pivoting sports
- Active adults whose knee gives way on stairs, slopes, or uneven ground
- Patients with persistent instability after a non-operative trial
- Patients with combined ACL + meniscus or cartilage injuries that benefit from surgical stabilization
How Dr. Pradhan approaches it.
We choose graft type based on your age, sport, and tissue — not a one-size-fits-all preference. For most adult athletes, the quadriceps or patellar tendon autograft offers the lowest retear rate; for some patients, hamstring or allograft is the right call.
Tunnel placement is anatomic — meaning the graft is positioned where your original ACL actually attached, not where the older textbook technique would have placed it. Tunnel placement is the single biggest predictor of long-term success, and it's where surgical attention belongs.
Concurrent meniscus or cartilage damage is addressed in the same operation when present, with preservation prioritized over excision.
What recovery looks like.
Most patients walk with crutches for the first 1–2 weeks and are off them by week 2–3. Range-of-motion work begins immediately; quad strengthening is the rate-limiting step.
Running typically begins at 3–4 months, agility at 5–6 months, and return to cutting sports at 9–12 months — based on objective strength and hop-test criteria, not the calendar.
We work directly with a small group of trusted Dallas-area physical therapists who follow the same return-to-sport protocols we do.
Frequently asked.
How soon after my injury can I have ACL surgery?
Usually two to six weeks. We wait until the knee has its swelling under control and reasonable range of motion — operating on a hot, swollen knee leads to stiffness afterward. Some patients need pre-habilitation; some are ready quickly.
Patellar, hamstring, or quadriceps graft — which one?
For most adult athletes returning to cutting sports, the quadriceps or patellar tendon autograft has the strongest long-term data. Hamstring autograft remains a reasonable option in select patients. We choose with you in clinic, based on your sport, history, and anatomy.
Will I be able to return to my sport?
Most patients (~85%) return to their pre-injury sport. Return is gated by objective criteria — quad strength symmetry, hop tests, and time from surgery — not just feel.
How long is the operation, and is it outpatient?
The operation takes roughly 90 minutes. It is performed outpatient under regional anesthesia and sedation. Most patients are home within a few hours.
Do I need a brace afterward?
For isolated ACL reconstruction without meniscus repair, a brace is optional and often skipped. If meniscus repair is performed, a hinged brace is used for the first six weeks.