ACL reconstruction in Canada

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.

There is no national benchmark for ACL reconstruction. The best measured Canadian figure is an average wait of about 210 days, from an Ontario survey in which 32% of patients waited longer than 180 days. Provincial portals report narrower clocks: British Columbia recorded an 8.4-week median from booking to surgery from March through May 2026, while Nova Scotia reported a 66-day median consultation wait followed by a 99-day surgical wait. At Pathway the timeline is 1–4 business days to consultation and 2–4 weeks from quote approval to surgery. See our ACL surgery wait times guide.

For many patients the deciding factor is time. Studies link longer delays between injury and reconstruction with higher rates of secondary meniscal and cartilage damage, and every month without a stable knee is a month away from sport, work, or training. Private surgery through Pathway means a consultation within 1–4 business days and surgery typically 2–4 weeks after quote approval, with sports-medicine surgeons who serve as team physicians for professional clubs. Whether it is worth it for you depends on your activity level, the stability of your knee, and how long the public wait would be in your province.

Pathway’s ACL surgeons are fellowship-trained sports-medicine specialists who also serve professional teams. Dr. Jihad Abouali performs more than 200 ACL reconstructions a year and over 2,500 in his career, is an Assistant Professor at the University of Toronto and McMaster University, and is Head Physician for the Scarborough Shooting Stars. Dr. Thierry Pauyo is Head Team Physician for the Montreal Canadiens, trained at Boston Children’s Hospital (Harvard) and the University of Pittsburgh Medical Center, and specializes in quadriceps-tendon ACL reconstruction. Dr. Jason Smith is Official Orthopaedic Surgeon for the Toronto Blue Jays and Toronto Maple Leafs. Dr. Jas Chahal is an Associate Professor at the University of Toronto with over 100 peer-reviewed publications.

Reconstruction replaces the torn ligament with a graft and is the standard operation for most complete tears. Primary repair re-attaches your own ligament and is only an option for a small group of patients with a fresh tear that has pulled off the bone cleanly, rather than torn mid-substance. Your surgeon decides from the MRI and the timing of the injury. Read our ACL repair vs reconstruction guide or the ACL repair page for the criteria.

Yes. Pathway offers ACL reconstruction in Toronto and in Montreal, where Dr. Pauyo performs quadriceps-tendon reconstruction at accredited surgical centres. Patients from British Columbia, Alberta, and the Atlantic provinces come to Pathway regularly: a virtual consultation within 1–4 business days, then flights, accommodation, and post-operative follow-up arranged around the surgical date, with rehabilitation completed near home. See the Montreal ACL reconstruction page or our out-of-province surgery guide.