The surgical approach: is to remove a torn ACL and replace with surrogate tendon. It is not an exact copy of the tendon for many reasons.
The challenge: is that the substitute ligament goes in at too steep an angle and can never stabilize the knee as well as the original ligament. Clinical expert Mary Ann Porucznik states “The incidence of a second injury to the anterior cruciate ligament (ACL) within the first 12 months after ACL reconstruction and return to sport in a young, active population has been reported to be 15 times greater than a previously uninjured cohort.” Substitute ligaments do not have the proprioception or fine-tuning position sensors of the original tendon. Finally, the rehabilitation time until full play can be six months to one year.
Physical Therapy After Surgery: After ACL reconstruction surgery, you’ll do physical therapy until you get back to your previous normal level of activity. For athletes, there is specific functional tests like a single leg hop test that will dictate a return to sporting activitiy. However, for most patients rehabilitation of their knee takes about four to six months. Physical therapy focuses on decreasing the swelling and promoting wound healing immediately post operatively. The next step is regaining full range of motion, which helps relieve knee pain, and then finally the strengthening phase of your knee and all of the surrounding musculatures of your core, hip, and ankles.