Ask the Expert: Dr. Thomas Wickiewicz, Orthopedic Surgeon, Answers Your Questions about ACL

Q1. My husband recently found out he tore his ACL playing basketball. Does it always mean surgery?

Sports that involve jumping, pivoting and rapid deceleration (such as basketball) require a stable knee. In general, if the individual wishes to maintain an active lifestyle that includes these actions, surgery is often recommended.

Q2. I had surgery on my ACL about 20 years ago after a sports injury. I remember it being pretty invasive and recovery taking a while. Is the procedure still the same?

Today the surgery is arthroscopic and bares no similarity to surgeries of 20 years ago. There are still incisions and some cutting if the person chooses to use their own tissue for the reconstruction. Return to daily life function is fairly quick, but is however tissue specific for the reconstruction. Return to sports is much slower: 6 to 12 months for something like basketball is within the norm.

Q3. My son is a high school athlete and plays on different teams all year around. Any tips for him to avoid ACL injuries?

Injuries to the ACL are classified as contact or non-contact. Contact injuries are inherent in the risk of the sport and prevention can be difficult short of not participating. Non-contact injuries, as are common in women’s sports such as soccer and basketball, have been the subject of much study. The causes for ACL injury are many, and prevention programs are not perfect. But there is some evidence that training programs emphasizing jump-landing techniques, and specific muscle training programs, may help. Some sports programs utilize these. Ask your trainer or coach. Another resource is your physical therapist. Some groups offer such classes

Q4. Are there any signs that might indicate an ACL injury? I’m not in a ton of pain but have noticed that something is “off” in terms of balance ever since soccer practice a couple of weekends ago?

Acute injuries to the ACL are rarely subtle; they are fairly dramatic and often associated with the person sensing a “pop” in their knee, and rapid swelling. If you are concerned, a physical exam, and sometimes an MRI, will determine the problem.

Q5: I’m a 30-40 year old, non-athlete, w/torn ACL. Surgery or not?

If your injury is to the ACL only, with no meniscal involvement, and your life style is sedentary, then conservative care is a realistic option. You should review your lifestyle, expectations and activity profile with the treating physician.

Dr. Thomas Wickiewicz is an Orthopedic Surgeon at Hospital for Special Surgery. He specializes in sports medicine, meniscus surgery, ACL surgery, and shoulder surgery. He spent eight years as Assistant Team Physician for the New York Giants, and he now serves as the Head Team Physician for all Division 1A College sports at St. Peter’s University. Dr. Wickiewicz has published over 100 scientific papers on his extensive research on knee and shoulder surgery and given more than 200 invited presentations.

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.


  1. I have done my acl reconstruction and its been one month after surgery….I feel like femur and tibia rub each other..I hear popping sound again when I walk…y is that so?is it coz surgery was a failure??
    But I have regained the stabiity when I walk and I feel the problems I had while climbing steps have all got cured.

    1. Hi Nikhil, thank you for your inquiry. Dr. Robert Marx, orthopedic surgeon, says that “what you described is normal in the first few weeks after ACL reconstruction and is not an indication that the surgery failed. If you have any further concerns, you should consult with your surgeon.”

  2. My husband 54 tore his ACL and Mcl May of 2015 surgery June 2015. Is a meth user. It is mid January still in therapy. Will he ever recover

    1. Hello, thank you for your inquiry. Recovery time varies and assessment of recovery is based on restoration of strength, range of motion, and proprioception (the awareness of the position of one’s body). It would be best to further discuss your husband’s recovery process with his treating physician.

  3. There is definitely a great deal to find out about this topic.

    I love all the points you made.

If you’d like to consider HSS for treatment, please contact our Patient Referral Service at 888-720-1982. For general questions and comments, reach us on Facebook or Twitter.