Expert Sports Injury
Care in San Diego

A sudden pop in your knee followed by swelling and instability can change the course of an athlete’s season, or even daily life for someone who’s active. The anterior cruciate ligament (ACL) is one of the most frequently injured structures in the knee, with more than 200,000 ACL tears occurring annually. For those facing this injury, the treatment conversation often comes down to two surgical options: ACL repair or ACL reconstruction. Each approach has its own benefits, risks, and recovery timelines, and understanding these differences is key to making the right decision for long-term knee health and a safe return to activity.

Read on to learn the differences between these two surgical treatment options, how non-surgical orthobiologics can help, and where to find the best ACL surgeon in San Diego.

What Is the Difference Between ACL Repair and Reconstruction?

When an ACL is torn, surgeons have two main ways to address it: repair or reconstruction. 

• ACL repair focuses on reattaching the torn ligament to the bone, but it’s only possible in very specific cases. Usually, the tear occurs close to where the ligament connects to the bone. 
• ACL reconstruction, on the other hand, replaces the damaged ligament entirely with a graft, which may come from the patient’s own tissue, often the hamstring or patellar tendon, or from a donor. 

Reconstruction is considered the standard approach because it works for most types of ACL tears and has a strong track record for long-term success. While repair is less invasive and can mean a quicker recovery, it’s much more limited in who it helps, making reconstruction the more common choice for most patients.

Who Is a Candidate for ACL Repair vs. ACL Reconstruction?

Not every ACL injury is treated the same way, and the type of surgery recommended depends on factors like age, activity level, and exactly how the ligament is torn:

• ACL repair is typically reserved for younger patients who have a specific type of injury, known as a proximal tear, where the ligament separates from the bone at its upper end. 
• ACL reconstruction, in contrast, is the go-to option for most people, especially athletes or anyone with a complete tear or one that occurs in the middle portion of the ligament. 

Top orthopedic surgeons will carefully decide which option offers the best chance for healing, stability, and a safe return to movement. 

What are the Success Rates and Risks for ACL Surgery?

When comparing outcomes, it’s important to weigh both the success rates and the risks of ACL surgery:

• ACL repair can be appealing because it often allows for a faster recovery, but studies show it carries a higher chance of retearing, especially in active patients. 
• ACL reconstruction, while requiring a longer rehabilitation period, has a proven track record of long-term durability and generally lower failure rates. 

With either option, there are still risks to consider, including knee stiffness, infection, or lingering instability if the ligament doesn’t heal as expected. Understanding these trade-offs can help you and your surgeon decide together on the approach that best balances healing time with long-term knee stability.

What Is the Recovery Time for ACL Surgery?

Recovery after ACL surgery isn’t just about the incision healing; it’s about regaining strength, movement, and confidence in your knee. With ACL repair, patients may return to light activity in as little as four to six months, since the ligament is reattached rather than replaced. 

ACL reconstruction typically takes longer, with most people requiring nine to 12 months before they can safely return to sports or high-impact activities, as the graft must fully heal and adapt to the body. No matter which procedure is done, physical therapy is the cornerstone of recovery by helping restore mobility and build muscle strength. 

Is ACL Repair or Reconstruction Better for Athletes?

For athletes, the choice between ACL repair and reconstruction often comes down to how demanding their sport is and the level of stability their knee needs. ACL reconstruction is widely considered the gold standard for athletes in pivot-heavy sports like soccer, basketball, and football, because it provides a stronger, more reliable foundation for quick cuts, jumps, and sudden changes in direction. 

ACL repair may be an option for a small group of athletes with very specific tear patterns, but it carries a higher risk of reinjury, which can sideline an athlete again. Ultimately, the decision about when and how to return to play depends on regaining full strength and stability through rehab. 

Non-Surgical Options: PRP and Orthobiologics for ACL Healing

Not every ACL injury requires surgery, and for some patients, non-surgical therapies can play a powerful role in healing and recovery. Treatments like platelet-rich plasma (PRP) injections and orthobiologics use the body’s own natural growth factors and regenerative cells to reduce inflammation, support tissue repair, and enhance recovery after injury. These therapies can be especially helpful for partial ACL tears or as a complement to surgery by improving healing and shortening downtime. 

How Do I Choose the Best Surgeon for ACL Surgery?

At San Diego Performance Orthopedics and Regenerative Therapy, Dr. Sanjum Samagh brings board-certified expertise in both ACL repair and ACL reconstruction by combining advanced surgical skill with innovative regenerative therapies to help you return stronger. 

We take pride in offering concierge-level, personalized care that supports you through every stage of recovery, from your first consultation to your return to peak activity. Patients across Encinitas, Leucadia, Del Mar, Solana Beach, Cardiff, Carlsbad, Oceanside, Torrey Pines, and North County San Diego trust Dr. Samagh for his precision, compassion, and ability to tailor treatment to fit each patient’s goals. 

Ready to get back to the activities you love with an ACL reconstruction or repair with the best orthopedic surgeon in San Diego?