Procedures If a doctor suspects an ACL tear, he or she will likely order an MRI to evaluate the ACL and to look for other injuries of ligaments and cartilage in the knee. A doctor may order X-Rays to check for fractures in the knee. The doctor will also give a thorough knee examination to determine the laxity (looseness), strength, and pain points within the joint. Not all ACL injuries require surgery. See your physician to discuss options appropriate for your age and level of activity. Depending on desired level of activity and degree of involvement in sports, non-operative management may be adequate. However, a doctor has many methods of repair should ACL repair surgery be necessary. A doctor may employ any of the common methods to reconstruct the torn ACL, including, but not limited to, replacing the ACL with a graft made of tendon from the central quadriceps tendon, hamstring tendon, patellar tendon, or a graft of an ACL of a cadaver donor. ACL tears are not usually repaired using suture to sew it back together.Certain steps can minimize your risk for an ACL injury. Women are more prone to ACL injuries than men in certain sports, and several explanations for this gender difference have been proposed: muscle strength and conditioning, quadriceps-to-hamstring muscle ratio, the effects of estrogen on ligaments and lower extremity alignment that predisposes them to the condition. Certain strength-training programs exist to reduce the risk of ACL tears, especially in women. Proper stretching and protective equipment may also reduce the risk of the injury. If you have incurred an ACL injury or are at high risk for one, avoidance of "cutting" sports will decrease your risk.