What to Ask Your Surgeon Before and After ACL Surgery

My approach to recovery from an ACL rupture has been to get as much knowledge as possible. The more I understood, the more confident I felt in the recovery.

There are more benefits. Sometimes, I was given bad advice which I was able to question. Other times I was able to keep faith with the process even when it felt like I wasn’t making progress.

You might want to have the surgery, do your rehab and think about it as little as possible. But if you are anything like me, you will want to face everything head on and not shy away from the details.

To understand as much as possible, I prepared questions for my surgeon that helped me get the full picture. Here is what I asked.

Before the Operation

What graft type will be used?

Your surgeon will share this with you anyway, but understanding where the graft is taken from is important for your rehab later.

For example, a hamstring graft may weaken your hamstring and you will need to be more careful with it in your early rehab. A quad tendon graft (I had this in my previous surgery) can heal back stiff and I needed some physio later to break down scar tissue in this area.

Will you repair or remove the meniscus?

Usually, the ACL is not the only thing you damage in your knee. The meniscus is essential cushioning between the femur and tibia bones.

It generally doesn’t heal well and in the past surgeons opted to remove the damaged part. This works in the short term and means you can get back to activity faster, but long term it leaves your bones unprotected. This can lead to irreversible arthritis and eventually a total knee replacement.

Your surgeon may not want to take a risk on repairing the meniscus if it is likely to fail. They might not share this decision with you, so it is crucial to ask and to decide for yourself.

Personally, I would always want the surgeon to try to repair the meniscus if possible. I have had meniscus repairs twice now and they have both been successful.

Which physio should I work with?

Your surgeon likely has recommended physios who know how they operate. Decisions on your rehab are more for the physio, but when they have a relationship with your surgeon it can make things easier.

There may also be specific surgery techniques, like graft types, and recommendations from the surgeon, like bracing your knee, that your physio should be on board with.

If your surgeon doesn’t have a physio recommendation, they can at least guide you on what to look for.

Can I go on the cancellation list?

Surgery can have a long wait time, especially in the UK, and asking for a cancellation list can save you weeks or months.

If you can be flexible and take surgery with a day or two of notice, you might get lucky and skip the queue. It’s always worth asking.

When will I have check-ups after surgery?

I had my surgeries in the UK and our healthcare can be spotty. Sometimes you get lost in the system and don’t realise that you should have had a check-up.

It’s a good idea to ask your surgeon when they want to see you after the operation. Usually it is at 6 weeks, 6 months and 12 months, but this can vary depending on your surgeon and procedure.

Other things to ask before surgery

• When will stitches or staples be removed?
• How soon after surgery can I fly?
• Can I get a copy of the MRI report?
• Where exactly will the tendon graft be harvested from?

After the Operation

Once you come round from surgery, your surgeon should visit you to explain how it went. If they don’t, make sure you chase this up. You want to understand exactly what was done while it is fresh in their mind. Here are the key things to ask:

Can I get a copy of the operation notes?

The operation notes are a detailed record of everything the surgeon did. They are invaluable for your physio and for any future consultations. Ask for a copy before you leave the hospital or at your first follow-up appointment.

What is the general health of my knee joint?

During arthroscopic surgery, the surgeon gets a close look at the inside of your knee. Ask them about the condition of the cartilage, whether there are any signs of arthritis or bone damage, and anything else they noticed. This information helps you and your physio plan your long-term recovery.

What happened to the previous graft?

If this is a revision surgery, like mine was, it’s important to understand why the first graft failed. Did it stretch over time? Did it fail due to a traumatic event that would have torn any ACL? Or was there a structural issue? The answer can influence your rehab approach and your expectations for returning to sport.

Were there any other issues?

Ask about the state of your other ligaments, particularly the MCL. Damage to secondary structures is common alongside an ACL tear and it may affect your recovery timeline.

Why this matters

Nobody will care about your knee as much as you do. Surgeons are busy, and the NHS system moves fast. Preparing questions in advance means you won’t forget anything important in the moment, and you’ll walk away with a clearer picture of what’s ahead.

I found that the more I understood about my injury, my surgery, and my rehab, the better I recovered. Knowledge gave me confidence, and confidence helped me push through the hardest parts of the process.