ACL Reconstruction in Canada

Surgical reconstruction of the anterior cruciate ligament using multiple graft options including All-Inside, BTB, and Quad tendon techniques with 4K arthroscopic visualization.

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★★★★★ 5.0 from 192+ Reviews

Real Patient Experiences

★★★★★

"Both our boys suffered simultaneous knee injuries from contact sports. They had to undergo ACL reconstruction and meniscectomy. The Pathway team was very helpful and attentive from A to Z. The whole team was a pleasure to work with."

— Marie Emond

ACL Reconstruction & Meniscectomy

★★★★★

"I had an amazing experience with Dr. Jihad Abouali for my ACL reconstruction. The entire process was smooth, professional, and stress-free. Dr. Abouali's expertise and precision made the surgery seamless, and my recovery has been going exactly as expected."

— Realtor Elango

ACL Reconstruction

★★★★★

"I had ACL reconstruction by Dr. Thierry Pauyo. He is incredibly skilled in knee surgeries and sports medicine. What impressed me most is his up-to-date medical knowledge. Joseph and Mike from Pathway were helpful, professional, and quick to respond."

— Sasan Arbabzadeh

ACL Reconstruction

Read More Patient Stories

What is ACL Reconstruction?

The anterior cruciate ligament (ACL) is one of the key ligaments that stabilizes your knee joint. When torn—often during sports involving sudden stops, pivoting, or jumping—the ACL cannot heal on its own in most cases.

ACL reconstruction replaces the torn ligament with a tissue graft, which acts as a scaffold for a new ligament to grow. The procedure is performed arthroscopically through small incisions, allowing your surgeon to see inside the knee using a camera while specialized instruments create tunnels and secure the graft.

At Pathway, our surgeons offer multiple graft options and techniques tailored to your anatomy, activity level, and goals—from recreational athletes to professionals.

Surgical Technology

4K Arthroscopic Visualization

Crystal-clear imaging for precision surgery

Both of our ACL surgeons use 4K imaging technology from Smith+Nephew to visualize the knee anatomy with exceptional clarity during surgery.

  • 4x the resolution of standard HD arthroscopy
  • Enhanced tissue differentiation for identifying structures
  • Photo documentation—see exactly what was repaired post-op

After your surgery, your surgeon can show you high-resolution images of exactly what was done inside your knee.

Smith+Nephew 4K Imaging System

4K Imaging System

Ultra-high-definition visualization that allows surgeons to see fine anatomical details with unprecedented clarity.

Technology by Smith+Nephew

Surgical Approaches

ACL Reconstruction Techniques

Our surgeons offer multiple approaches tailored to your specific needs

Dr. Jihad Abouali

Dr. Jihad Abouali

All-Inside & BTB Specialist

All-Inside ACL Technique

Dr. Abouali is one of the highest volume All-Inside ACL surgeons in Canada. This technique uses smaller sockets instead of full tunnels, preserving bone stock.

  • FlipCutter 3 from Arthrex
  • Bone-preserving socket fixation

BTB Graft with Resorbable Screws

Bone-patellar tendon-bone (BTB) graft secured with resorbable screws that integrate and become like bone over time.

BTB Graft with Resorbable Screws

Resorbable screws integrate with bone over time

View Dr. Abouali's Profile
Dr. Thierry Pauyo

Dr. Thierry Pauyo

Quad Tendon ACL Specialist

Quad Tendon ACL Reconstruction

Dr. Pauyo is a specialist in Quad ACL reconstruction, harvesting the quadriceps tendon for a strong, reliable graft.

  • QUAD-TRAC harvesting system from Smith+Nephew
  • Very strong graft tissue

ULTRABUTTON QUAD Fixation

Suspensory fixation using ULTRABUTTON QUAD provides secure graft attachment with excellent biomechanical properties.

ULTRABUTTON QUAD Fixation

Suspensory fixation for secure graft attachment

View Dr. Pauyo's Profile

See the All-Inside Technique

Watch how the bone-preserving All-Inside ACL technique works

All-Inside ACL Reconstruction technique demonstration

Graft Options

Your surgeon will recommend the best graft type based on your anatomy and goals

Quadriceps Tendon (Quad)

Strong, thick graft harvested from above the kneecap. Growing in popularity for its biomechanical properties.

  • ✓ Very strong graft
  • ✓ Less anterior knee pain
  • ✓ Large graft diameter available

Bone-Patellar Tendon-Bone (BTB)

Classic graft with bone plugs on each end for bone-to-bone healing. Often preferred for high-level athletes.

  • ✓ Bone-to-bone healing
  • ✓ Well-established track record
  • ✓ Excellent for pivoting sports

Hamstring Tendon

Tendons from the inner thigh bundled to create the graft. Smaller incision and less anterior knee pain.

  • ✓ Smaller harvest incision
  • ✓ Less kneeling discomfort
  • ✓ Good for recreational athletes

Your ACL Reconstruction Specialists

High-volume sports medicine surgeons with specialized ACL expertise

Dr. Jihad Abouali, ACL Surgeon

Dr. Jihad Abouali

Knee & Shoulder Sports Medicine

200+ ACL reconstructions per year. All-Inside & BTB specialist.

View Profile Dr. Thierry Pauyo, ACL Surgeon

Dr. Thierry Pauyo

Hip, Knee & Shoulder Sports Medicine

Quad ACL specialist. Official surgeon for the Montreal Canadiens.

View Profile

Your Recovery Journey

What to expect after ACL reconstruction

Week 1

1

Rest & Protect

Brace, crutches, pain management

Weeks 2-6

2

Early Rehab

Range of motion, quad activation

Months 3-6

3

Strengthening

Progressive exercises, light jogging

Months 9-12

4

Return to Sport

Sport-specific training, clearance

4–6 weeks

Off Crutches

Walking without assistance

3–4 months

Light Jogging

With PT clearance

9–12 months

Full Sports Return

After passing return-to-sport testing

Could You Be a Candidate for ACL Repair?

For certain tear types—particularly proximal tears where the ligament has pulled off the bone—ACL repair may preserve your native ligament without needing a graft. Dr. Abouali is one of Canada's leading ACL repair specialists.

Learn about ACL Repair

Frequently Asked Questions

The best graft depends on your activity level, anatomy, sport, and personal factors. Your surgeon will discuss the pros and cons of each option during your consultation and make a recommendation tailored to your goals.

The All-Inside technique creates sockets instead of full tunnels in the bone, preserving more bone stock. This can be beneficial if revision surgery is ever needed in the future and may result in less post-operative pain.

Most athletes return to sport between 9-12 months after surgery. This timeline allows the graft to fully incorporate and mature. Return-to-sport testing helps ensure you're ready before resuming competitive play.

Yes, ACL reconstruction is typically performed as an outpatient procedure. Most patients go home the same day with crutches, a brace, and pain management instructions.

No referral is required. You can book a consultation directly. Having a recent MRI is helpful but not mandatory—we can arrange imaging if needed.

Ready to Get Back in the Game?

Schedule a consultation to discuss your ACL injury and treatment options with one of our specialists.

Request a Consultation (647) 553-1297