Dr. Jeff Abrams
Princeton, New Jersey

You should have surgery to repair the ACL if you are at high risk for further injury due to your lifestyle (sports), if you experience repetitive giving way (buckling) during walking or steps, or if you experience associated knee injuries such as meniscal tears or associated ligament injuries (i.e. MCL).

F. Alan Barber MD, FACS
Plano, Texas

The ACL is the main stabilizing ligament of your knee. When it is torn, any vigorous pivoting may cause your knee to buckle. When your knee buckles, you may tear your knee cartilage and cause more damage. This damage leads to arthritis over time. If you are interested in continuing to pivot or twist aggressively in your sports or at work, surgery to repair the ACL will allow you to continue your activities while avoiding further damage to your knee.

Dr. Don Johnson
Ottawa, Canada

You only need to have an ACL reconstruction if you are physically active in pivotal sports such as basketball, volleyball, or soccer. Only about 10% of patients who have injured their ACL can return to those sports without an ACL reconstruction. Some patients can use a brace and modify their activities and resume sports without surgery. The best option for the young pivotal athlete is to have a reconstruction to prevent episodes of giving way due to the ACL laxity. With each of these re-injuries, there is risk of further damage to the meniscus and articular cartilage. The ACL can be reconstructed with fairly predictable results, but the long-term outcome depends on the damage to the meniscus and articular surface. The goal of the ACL reconstruction is to provide a stable knee so as to prevent further damage to the meniscus and articular cartilage.

Dr. Hugh West
Salt Lake City, Utah

Not everyone needs ACL surgery. Each individual person has to make a decision about ACL surgery that takes into account his or her activity level, and how loose his or her knee is after the injury. Age used to be more of a factor, but it is becoming less important now as the techniques become better and the surgery becomes easier and more reliable. It's a black and white picture if you are involved in active sports that involve cutting or pivoting and you have a loose knee. In which case, surgery would be recommended. For everyone else, whether or not you should have surgery depends upon how often the injury makes your knee feel unstable or prevents you from doing something that you want to do.