ACL Surgery: Long-Term Care

Roughly a third of young, athletic people who have their anterior cruciate ligament (ACL) repaired suffer another tear within a few years. Learn how to maintain your ACL and protect your repair.

Benefits of Surgery

Initial management of an ACL tear focuses on reducing pain and swelling with rest, ice, compression, and elevation. Physical therapy follows in the week after the initial injury to restore range of motion to the joint.

When surgery is chosen over conservative management, the ACL is repaired with a grafted ligament. Intense rehabilitation follows surgery—sometimes for up to a year. While surgery can help an athlete return to their previous level of play in most cases, there is also a high risk of reinjury.

Runner is protective of knee after ACL surgery
skaman306 / Moment / Getty Images

Possible Future Surgeries

While the goal of most surgeries is a somewhat permanent solution, ACL injuries might be the exception. Most people who have ACL injuries repaired surgically return to full activity and sports eight to 12 months after their surgery.

There is a huge risk for reinjury after ACL repair, though, and the amount of time that passes between surgery and return to full activity seems to be the best protective factor. Research shows that for every month that a return to full play was delayed after surgery, the rate of reinjury was reduced by about 51%. 

In the first two years after ACL reconstruction, about a third of athletes who returned to the same level of play as before their injury tore their ACL in the same or opposite knee. For those who participate in a lower level of play, the reinjury rate is about 8%.

If reinjury occurs, the options are the same as with the original decision for surgery. Conservative management with physical therapy is an option, but younger athletes who want a return to full play of their desired sport may need to have their ACL surgically repaired again.

Lifestyle Adjustments

As with any surgery, taking care of your physical health will help improve your recovery. With ACL surgery, there are specific things you can do, as well, to prevent reinjury and extend the life of your ACL repair:

  • Use crutches or support braces as directed by your doctor.
  • Participate in any recommended physical therapy or rehabilitation.
  • If you are an athlete, delay your full return to play as long as possible.

Delayed return to play can help prevent reinjury and osteoarthritis.

A Word From Verywell

Surgical repair of a torn ACL isn’t the end of the recovery process. Rehabilitation requires long-term physical therapy, and a delay in returning to the same level of play for athletes. Make sure to talk to your doctor about your activities, and make a plan together about when it is safe to resume your pre-operative level of activity.

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Article Sources
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  1. Paterno MV, Rauh MJ, Schmitt LC, Ford KR, Hewett TE. Incidence of second ACL injuries 2 years after primary ACL reconstruction and return to sportAm J Sports Med. 2014;42(7):1567-73. doi:10.1177/0363546514530088

  2. Grindem H, Snyder-Mackler L, Moksnes H, Engebretsen L, Risberg MA. Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study. Br J Sports Med. 2016;50(13):804-8. doi:10.1136/bjsports-2016-096031

  3. Friedberg RP. Anterior cruciate ligament injury. UpToDate. Updated March 4, 2020.