Mr Mark Webb

ACL Repair vs. Reconstruction: Which is Best for Me?

Table of Contents


ACL (anterior cruciate ligament) injuries can primarily be treated in two ways: ACL repair and ACL reconstruction. Both procedures aim to restore knee stability and function, but they differ in their approach. In this blog post, we will compare ACL repair and reconstruction, examining their benefits, success rates and the factors that need to be considered when determining which is best for you. By understanding the nuances of each approach, you can make an informed decision about the most suitable treatment for your ACL injury.

ACL Repair - Preserving the Native Ligament

Explanation of ACL repair procedure:

  • Sutures and/or specialised anchors are used to reconnect torn ligament ends.
  • Suitable for partial tears or proximal tears near the ligament’s attachment.

Benefits of ACL repair:

  • Preservation of the natural ligament.
  • Potential for faster recovery.
  • Minimal disruption to knee anatomy.

ACL Reconstruction - Rebuilding with Grafts

Explanation of ACL reconstruction procedure:

  • Using graft tissue to create a new ligament.
  • Autograft which is using your own tissue (hamstring, patella or quadriceps tendon).
  • Allograft which is using donated tissue.
  • Suitable for complete tears or inadequate tissue quality for repair.

Benefits of ACL reconstruction:

  • Reliably restores stability to the knee joint.
  • Lower risk of re-rupture.
  • Long term outcome data.

Factors to Consider for ACL Repair and Reconstruction

Patient-Specific Factors:

  • Age, activity level, and overall knee health.
  • Associated injuries (meniscus tears, cartilage damage).
  • Personal preferences and goals.

Surgical Considerations:

  • Surgeon’s expertise and experience.
  • Rehabilitation protocols and expected recovery time.
  • Potential risks and complications.

Shared Rehabilitation Process

Postoperative rehabilitation similarities for both ACL repair and reconstruction.

Goals of rehabilitation, including regaining strength, range of motion, and stability.

The importance of adhering to rehabilitation protocols for optimal outcomes.

There is a trend in evidence that suggests recovery time is reduced following a repair.


When deciding between ACL repair and reconstruction, several factors should be taken into account, including the extent of the ACL injury, associated knee injuries, and individual patient considerations. ACL repair offers the advantage of preserving the native ligament and potentially allowing for a faster recovery. On the other hand, ACL reconstruction provides a stronger, stable knee joint, with a lower risk of re-rupture. Consultation with a qualified orthopaedic specialist is crucial for an accurate diagnosis and personalised treatment recommendation. They can guide you through the decision-making process, considering your specific circumstances, and help you regain knee function, stability, and return to an active life.