ACL Reconstruction and Repair Surgeon

Are you an athlete who participates in sports that involve jumping or quick stopping? If so, you may be at risk of tearing your anterior cruciate ligament, or ACL. An ACL injury is one of the most common injuries suffered by athletes. ACL surgeon, Doctor Riley J. Williams provides diagnosis as well as surgical and nonsurgical treatment options for patients in Manhattan, Brooklyn, New York City and surrounding areas who have sustained an ACL injury. Contact Dr. Williams’ team today!

What is a torn ACL?

The anterior cruciate ligament, or the ACL, is one of the four main ligaments that connect the shinbone (tibia) to the thigh bone (femur). The ACL and the posterior cruciate ligament (PCL) form an “X” in the middle of the knee joint. These two ligaments are crucial for stabilizing the knee joint and for preventing abnormal knee movement that could cause injury. Specifically, the ACL prevents the tibia from sliding anteriorly relative to the femur. The ACL and the PCL both help to provide stability during the rotation of the knee.


ACL Tear

A torn ACL is one of the most common knee injuries that patients, especially athletes, experience. The ACL may stretch or tear following a sudden directional change, a landing hard from a jump, or a direct blow to the knee. These actions can cause the ACL to become loose, stretched, partially torn, or completely torn. Fortunately, many advancements have been made in the treatment  a  ACL injuries. Dr. Riley Williams, orthopedic knee surgeon, diagnoses and treats athletes and other patients experiencing who have ACL injuries in Manhattan, Brooklyn, New York City, NY and surrounding areas. Dr. Williams is a leading researcher and top surgeon who provides modern treatment strategies in the area of knee ligament injuries and tear.

What is anatomic ACL reconstruction?

Anterior cruciate ligament (ACL) reconstruction is a surgical technique performed to replace an injured ACL ligament. This surgery has been performed for many decades. However, ACL reconstruction techniques have advanced greatly over the past 20 years. Currently, ACL reconstruction is performed arthroscopically. Anatomic ACL reconstruction is the type of procedure surgeons typically perform today. This method uses the same technique as a regular reconstruction however, the surgeon uses precision to place the graft in the ligaments’ native insertions points on both the femur and tibia. This means the inserted ACL graft is placed in the same location and has the same dimensions as the original ACL.  Accurate placement of the ACL graft facilitates normal knee kinematics and allows for an optimal recovery. This type of procedure is best performed by an experienced orthopedic surgeon such as Dr. Williams.

During ACL reconstruction, the existing damaged ligament is removed and replaced with a tissue graft. This graft is typically either an autograft or an allograft. An autograft is a tissue sample taken directly from the patient. Examples of commonly used autografts for ACL reconstruction include a central third patellar tendon graft, hamstring tendon graft, and quadriceps tendon graft. An allograft, on the other hand, is a tissue sample obtained from a donor. These grafts are cleaned, prepared and distributed by  a tissue bank. Both types of grafts successfully replace the damaged ACL; the type used generally depends on the patient and their specific injury.

What is an ACL repair?

ACL repair is a surgical technique performed to preserve and reattach the damaged ligament. ACL repair is similar to ACL reconstruction because they are both minimally invasive, arthroscopic procedures. ACL repair differs from ACL reconstruction in that the ligament is not replaced and is instead reattached and re-secured to the bone. In a typical ACL injury, the ACL is either torn in the middle, resulting in two detached ligament pieces, or the ligament detaches from the femur. In ACL repair, Dr. Williams creates small incisions in the knee to visualize the ACL and surrounding tissues. He then manipulates the existing ligament and ensures it is placed in the original anatomic footprint. Dr. Williams then performs the ACL repair to reattach the ACL to the femoral ACL footprint. The indications for this method require that the injured ACL be intact and of good tissue quality. The results of ACL repair are still under investigation. Dr. Williams will advise you as to whether this approach is suitable for your type of ACL injury.

Which is better ACL Repair or ACL Reconstruction?

Although both ACL repair and ACL reconstruction are successful techniques to treat ACL tears or injuries, ACL reconstruction is usually favored by top ACL surgeons. Dr. Williams recommends ACL reconstruction instead of ACL repair because ACL reconstruction often allows the patient to return to their normal range of motion and level of flexibility in the knee. ACL repair does have a shorter recovery time; however, the ligament may be less able to withstand high demand knee activities than was possible before the injury.

It is extremely important to see an experienced orthopedic surgeon such as Dr. Williams if you have experienced a torn or injured ACL. Dr. Williams has successfully treated thousands of patients and athletes with torn ACLs.  HE can determine the best, most appropriate route of treatment for the patient’s injury.

 How is ACL reconstruction surgery performed?

An arthroscopic ACL reconstruction is minimally invasive and involves the surgeon making a few small incisions in the knee. Through these incisions, Dr. Williams can remove the damaged ACL and replace it with the new graft.

To attach the graft, Dr. Williams creates tunnels in the tibia and the femur at the place where the original ligament is attached to the bone within the knee. The graft is threaded through these tunnels and secured in place with screws, anchors, or other devices. Dr. Williams takes care to place the graft in the original footprint of the previous ligament. This highly technical process allows the patient to achieve full range of motion, knee stability and normal function following rehabilitation. Dr. Williams also tests the flexibility and movement of the new tissue before stitching the small incisions and wrapping the knee.

How long is the recovery after ACL reconstruction?

ACL reconstruction is an outpatient surgery, meaning that patients can go home the same day that they have the procedure. Immediately following surgery, patients are placed in a sturdy brace, and instructed to rest the joint, use ice, and to elevate the knee to help promote healing and prevent unnecessary strain on the new ligament. Dr. Williams will prescribe medication to help manage pain while healing to be taken exactly as instructed. Patients are also advised to use crutches to lessen the weight placed on the knee. It is extremely important to follow the protocol given by Dr. Williams, which will specify how long to use the crutches. Dr. Williams typically recommends crutch use for the first week, with a gradual increase of weight bearing thereafter.

The most important step of the recovery process is the physical therapy regimen prescribed by Dr. Williams. This plan will vary slightly for each patient, depending on their goals, health, and injury.  Physical therapy begins directly after surgery and will start with gentle flexibility exercises. Eventually, patients can begin more strenuous exercises to increase the strength of the knee. Patients are released to perform some early physical activities 3-4 weeks following surgery. Most patients can anticipate returning to the gym for resistance exercise after 6 weeks.  Patient are typically able to start running and jogging at 3 months following surgery.  Depending on how well the patient follows Dr. Williams’ recovery plan, they can return to their regular pivoting sporting activities 6 to 9 months after ACL reconstruction.

For more information regarding anterior cruciate ligament reconstruction or ACL repair as well as anatomic ACL reconstruction and the excellent treatment options available for your torn ACL, please contact the office of Riley J. Williams, MD, orthopedic knee surgeon serving Manhattan, Brooklyn, New York City, NY and surrounding areas.  


HSS Sports Medicine Institute West Side
610 W 58th Street
New York, NY 10019

HSS Brooklyn
148 39th Street, 7th Floor
Brooklyn, NY 11232

Office Hours

Monday-Friday: 9:00 am – 4:30 pm
Fax: 212-774-2895