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ACL Repair VS. Reconstruction

ACL Repair VS. Reconstruction
ACL Repair VS. Reconstruction

ACL injuries are relatively common among athletes, especially when involved in sports with sudden stops, pivoting, and change in direction. When faced with an ACL tear, the decision between ACL repair and reconstruction can be a challenging one to make.

To help you make an informed choice, let's dive into the key differences and benefits of repair and reconstruction.


ACL Repair is a minimally invasive procedure that involves reattaching the torn ends of the ligament, aiming to restore its function and stability. This approach is typically reserved for specific tears, where the ligament tears off a small piece of the bone or where the use of othobiologic material is used to help aid the body's natural healing.

Advantages of ACL Repair:

  • Preservation: With ACL repair you preserve your knee’s natural anatomy, resulting in a more natural feeling.
  • Short Recovery: Compared to reconstruction, a repair generally leads to a quicker recovery. Rehabilitation is involved soon after, using physical therapy to strengthen and restore full functionality.
  • Lower Risk of Complications: As ACL repair utilizes the patient's own tissues, the risk associated with harvesting grafts from other parts of the body is avoided.

Considerations for ACL Repair

  • Suitability: ACL repair is suitable for individuals with specific qualifications. The decision relies on factors such as tear location, tear pattern, age, and activity level.
  • Healing Potential: ACL repair relies on the body's natural healing process. Therefore, it may not be recommended for individuals with poor tissue quality, previous ACL injuries, or concurrent knee damage.


ACL Reconstruction involves replacing the torn ligament with an autograft, typically sourced from the patient's own hamstring tendons, patellar tendon, or a donor graft. This procedure is more commonly performed when the tear is significant, or when repair is not a viable option. This is a great choice to effectively restore knee function because it addresses the root cause of the tear, helping athletes feel stronger than they ever were.

Advantages of ACL Reconstruction

  • Reliable: Reconstruction outcomes have been extensively studied and refined over the years, leading to predictable results and a lower risk of a re-tear.
  • Confidence: Having confidence as an athlete to return to your sport is vital to your athletic success. With ACL reconstruction, patients can feel ready to perform confidently due to being far less likely to experience a repeat injury.
  • Applicability: Reconstruction is suitable for a broad range of patients, including those with complete tears, multiple ligament injuries, and those involved in high-demand sports or activities.

Considerations for ACL Reconstruction

  • Lifestyle: Typically the best candidate for ACL reconstruction is someone in good health that lives an active lifestyle, or participates in a high-intensity sport that demands a lot on your joints.
  • Complete Tear: If your injury is a complete tear, and other parts of your knee are damaged, reconstruction might be the best choice for you.

When faced with an ACL injury, the choice is not always straightforward. Both techniques have their advantages. A consultation with the expert Orthopedic Surgeon, Dr. Mithoefer, will help you make an informed decision that will provide you with long-term knee stability.

Dr. Kai Mithoefer is board certified in both Orthopedic Surgery and Orthopedic sports medicine specialist. Dr. Mithoefer is an internationally recognized specialist for complex shoulder and knee injuries with over 15 years of experience with the treatment of sports-related injuries. Dr. Mithoefer has published more than 100 scientific articles and book chapters and is a frequent speaker at national and international orthopedic meetings.

  • American Academy of Orthopaedic Surgeons
  • American Orthopaedic Society for Sports Medicine
  • Arthroscopy Association of North America
  • International Cartilage Regeneration & Joint Preservation Society (ICRS)
  • American Academy of Regenerative Medicine