I recommend ACL reconstruction for patients with knee instability and: Active adult patients involved in sports requiring pivoting or turning, Active adult patients with jobs, particularly heavy labour, requiring pivoting or turning, Older patients (e.g. above 50) who compete at an elite level and do not have degenerative change in their knees, Children or adolescents with ACL tears - a modified technique can be used to reduce risk of injury to the growth plate, and Athletes with other injuries to their knees as well as ACL tear –ligaments such as the PCL (posterior cruciate ligament) LCL (lateral collateral ligament), menisci and cartilage. Particularly for some meniscus tears, a better result can be had if the repair is done at the same time as an ACL reconstruction.