ACL Reconstruction Surgery

Your ACL is a strong band inside your knee that keeps your shin bone from sliding too far forward and helps with cutting, pivoting, and stopping fast. Think of it like a seatbelt for your knee.

ACL tears are a common injury in sport (especially soccer, basketball, skiiing), but also happen in everyday life—usually from a quick twist, sudden stop, or awkward landing. Your knee feels unstable, like it might “give way.”

ACL reconstruction surgery restores stability in the knee by replacing the torn band with a new tendon (called a graft).

In less common cases, the surgeon may repair the band by sewing it back together.

If knee instability/ pain is keeping you from sport, work, sleep, or simple daily movement, time matters. Exploring a private pathway gives you more choice, control, and flexibility while staying within Canadian regulations.

Timing

The number one reason you might consider a private ACL surgery is time. Instead of waiting months for surgery, private clinics often offer surgery within weeks. For many, this generally means less pain and faster return to sport and daily activities.

Choice and control

Going private generally gives you a sense of control, which can be reassuring during a difficult time. When you choose a private surgeon, you can:

• Select a certified orthopaedic surgeon and an accredited clinic that fits your needs.
• Select the clinic location (often out-of-province).
• Plan surgery around your own schedule.

Clarity upfront

Private pathways typically provide a clear quote and date, so you can arrange time off, caregiver help, and rehab. This certainty can ease anxiety and help families plan for recovery.

Preventing further decline

• Instability risks: Repeated “giving‑way” episodes while waiting can damage meniscus and cartilage, increasing arthritis risk and making surgery more complex.
• Deconditioning: Prolonged delay can worsen quad/hip weakness and neuromuscular control, lengthening rehab.
• Season and scholarship timelines: Athletes may protect opportunities by aligning surgery and rehab with key dates.
• Mental load: Reduces time living with knee uncertainty, bracing limits, and activity restrictions.

1. ‍Confirm your diagnosis. Most patients start with a family doctor or specialist who confirms that ACL surgery is needed.
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2. Research. Explore surgeons who specialize in private ACL surgery.
   • You can find surgeons in Vancouver, British Columbia; Calgary, Alberta; Toronto, Ontario; and Montréal, Québec on our app, and review qualifications, as well as pricing.
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3. Schedule an initial consultation. Most surgeons offer in-clinic and online consults.
   
   • Consultations are usually booked within days or a few weeks.
   • Note: expect a consultation fee between $150 - $350.
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4. Consultation. The surgeon will review your condition, symptoms, and any previous treatments or diagnostics, such as x-rays or MRIs.
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5. ‍Post consultation. The surgeon will then review your case and provide surgical options based on your needs; review the risks and expected outcomes; and present pricing and scheduling options.
   
   • Because the procedure is not covered by your provincial health plan when done privately, you’ll need to review the quoted cost and consider payment options (out-of-pocket, private insurance, or financing).
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6. Schedule your surgery date. Once you confirm the procedure and payment, the clinic will schedule your surgery—generally within a few weeks.
   
   • Plan for travel and accommodation, since the surgery will likely take place outside your home province.
   • Expect pre-surgery preparation, and possibly some pre-surgery tests.

The surgery takes 1-2 hours, and you'll likely go home the same day.

It involves small cuts and a camera (arthroscopy). They remove the torn ACL, drill tiny tunnels in your thighbone and shinbone, thread the new tendon through, and lock it in place with screws or buttons. Your body grows into it and makes it your “new ACL.”

This new tendon comes from you (autograft hamstring, patellar tendon, or quadriceps tendon) or a donor. For teens and active athletes, using your own tendon is most common because it’s more durable for high-intensity sports.

The recovery process varies patient to patient. Your recovery might look quite different, so please seek further guidance from your surgeon. In general here is what you can expect:

Week 1:

• Pain, discomfort, emotion, more pain, stiffness, frustration. Week 1 is not fun.
• Goals: Pain management, inflammation control, surgical graft protection, initial basic movement.

• Activities:
  
  • Same day discharge (usually).
  • Crutch-assisted walking with little physio-directed weight bearing.
  • Basic exercises such as ankle pumps, quadriceps contractions, and passive range of motion exercises (only as directed).
  • Pain medication management and wound care (it will be advantageous to have a friend, family member, or caretaker support you for both in the first few days).

Weeks 2-4:

• The next 3 weeks are still characterized by significant discomfort, swelling, frustration, and emotional highs and lows.
• Goals: Restore knee extension to 0 degrees, achieve 90-120 degrees of flexion, quadriceps activation, start rehab.

• Activities:
  
  • Continuing to use crutches, and potentially transitioning to just one crutch or a cane.
  • Increase walking and weight-bearing, practicing normal walking patterns to avoid developing a limp.
  • Daily exercises and physio focused on a developing range of motion and simple strength building exercises.

Weeks 5-12:

• Focus and diligence on exercises will likely pay off, and you'll likely be able to walk again unassisted and return to driving.
• Goals: Achieve fill range of motion (0 to 130 degrees), increasing physical therapy, walk unassisted, resume most normal activities.

• Activities:
  
  • More challenging physical therapy in order to improve range of motion and build strength.
    
  • Daily exercises. Possibly low impact activities like swimming and stationary cycling (only if cleared by healthcare team).
  • Walking longer distances—transitioning from the use of walking aids around week 6-8.

Weeks 13-52:

• The worst of the recovery is likely behind you. But you'll need to stay on top of physical therapy and listen carefully to your body in the year post operation (and beyond).
• Goals: Return to low impact sports and hobbies, achieve 90% strength symmetry between legs, focus on long-term knee health.

• Activities:
  
  • Physical therapy may continue the entire first year post operation, gradually bringing you back to your activity levels pre-surgery.
  • You will be able to return to low impact sports like golf, tennis, swimming, or cycling. For anything high impact, please consult your surgeon and physio. Most functional recovery happens within one year of surgery, but many patients need to continue working up to pre-injury levels of activity for up to 2 years.

ACL reconstruction surgery is a major surgery with significant costs. Private clinics in Canada typically charge $8,000 to $18,000. In the United States, the average cost for ACL reconstruction is CA$48,000.

Costs vary so much because of location, surgeon experience, facility type, complexity, and included services (some clinics offer all-inclusive, while others charge separately for anesthesia, followup care, etc.).

What’s usually included in the cost:

• Surgeon’s professional fee
• Accredited facility fee and nursing care
• Anesthesia/anesthesiologist fee (varies by clinic)
• Standard post-operative follow-up appointments
• Basic surgical supplies and graft (autograft or allograft policies vary by provider)

What may be additional:

• Pre-operative imaging (MRI/updated imaging if needed)
• Custom bracing
• Physiotherapy packages and sports rehab
• Additional consults or second opinions

Insurance and financing options

• Private health insurance: Some plans may cover part of the costs, such as hospital fees or implants. It’s important to check your policy directly.
• Financing plans: Many clinics offer monthly payment options to help spread out the cost. Learn more about your financing options here.‍
• Medical Expense Tax Credit (METC): This is a non-refundable credit that reduces your taxes when you pay out-of-pocket for eligible medical expenses. Learn more about how to claim METC for private surgeries.

For more information on costs, check out Private ACL Surgery Cost in Canada: What to Expect.

Choosing your surgeon is one of the benefits of going the private route. Here is what to consider when making your choice.

What to look for

• Experience. Ask how many ACL surgeries they perform each year. Volume and familiarity with the procedure can matter.‍
• Credentials and training.
  
  • ‍Confirm your surgeon is a licensed through their provincial college (e.g., CPSO in Ontario, CPSBC in BC, CPSA in Alberta).
    
  • Ensure they are certified through the the Royal College of Surgeons of Canada (FRCSC).‍
• Specialization. Some surgeons increase their expertise in this area by pursuing additional 1-2 year fellowships for orthopaedic sports medicine, ACL reconstruction, arthroscopy, ligament reconstruction.‍
• Accreditation of the clinic or hospital. Make sure the clinic is accredited by national bodies such as Accreditation Canada or the Canadian Association for Accreditation of Ambulatory Surgical Facilities (CAAASF).‍
• Support services. Look for clinics that offer coordinated aftercare.

Questions to ask during your ACL surgery consultation

Another benefit of private surgery is time spent with the surgeon. The consultation will be between 30-60 minutes (but possibly 2hours for complicated cases). Your surgeon should answer most of the questions below, but be sure to bring 5-7 that are important to you.

Surgeon and surgery plan

• How many surgeries do you perform each year?
• What are your infection rates? Re-tear rates?
• Do you treat athletes at my level?
• What exactly is torn (ACL only vs meniscus, cartilage, MCL/LCL, posterolateral corner)?
• What graft do you recommend for me (hamstring, patellar tendon BTB, quadriceps, allograft) and why?
• Fixation: what devices will secure the graft (screws, buttons), and long‑term outcomes with them?

• What anesthesia do you recommend (local/regional + sedation vs general) and why?
• Is this outpatient or will I stay overnight? In a hospital or ambulatory surgery center?

Post-surgery

• What’s my expected timeline for:
  • Off crutches, out of brace
  • Jogging
  • Cutting/pivoting drills
  • Return to sport clearance (based on objective testing)
• How closely do you coordinate with my physiotherapist? How often are follow‑ups?
• What signs after surgery should prompt me to call you or go to the ER?
• Who do I contact for questions after surgery (direct line/email)? How quickly do you typically respond?
• If complications occur, how are they managed and by whom?

Costs and logistics

• What exactly is included in my quote? What could add cost?
• If a complication occurs, how are costs handled? Is there a revision policy?
• How are follow‑ups managed if I’m traveling from another province?