Questions to Ask a surgeon BEFORE You Have ACL Surgery
What are my graft options?
The most common options for ACL grafts are autografts, meaning that the surgeon will use tissue from your own body to create a new ACL.
The most common autografts are patellar tendon (also called bone-patellar-bone) grafts, hamstring grafts, and quadriceps tendon grafts.
If you’re an athlete and a surgeon recommends an allograft or cadaver graft (aka a graft taken from a deceased person), please seek a second opinion.
Do I really need surgery?
The decision is ultimately up to you, but asking this question to your potential surgeon and rehab team is important. Some recreational athletes can successfully manage to return to activity without surgery. Often athletes whose sports involve explosive movements and change of direction often need surgery to perform at the level they want.
Do you recommend prehab?
The answer to this should be yes. It’s important to gain as much range of motion, maintain strength, and minimize quadriceps atrophy prior to surgery.
How many surgeries do you perform/year?
While there isn’t a specific number of surgeries per year that indicates a good surgeon, generally speaking you want someone who does a lot of ACLs (and does them well). I wouldn’t recommend you find a surgeon who performs ACL reconstruction every once in a while.
What are your outcomes?
Again, quantity and quality are important. You want a surgeon who performs ACL reconstructions often AND well.
Do you have a protocol? If so, do you view it as a guideline or set in stone?
Protocols are useful as guidelines, but not everyone progresses through post-operative ACL rehab in the exact same manner. Finding a surgeon who understands this and works in conjunction with rehab providers is ideal.
When AND HOW do you generally recommend athletes get cleared to return to sport?
No one should recommend that anyone be cleared prior to 9-months post-operatively, especially youth athletes.
Research indicates that the majority of athletes who undergo ACL reconstruction can safely return to sport between 9-12 months post-op with appropriate rehab. While time since surgery is important, it shouldn’t be the only factor.
Objective criteria such as quadriceps strength, vertical & horizontal hop testing. and ability to change direction should also play a role in the return to activity discussion.