You twist your knee mid-dribble, feel a sharp pop, and within an hour your knee is swelling up like it is not even yours. If you are in Commack or anywhere along the Long Island corridor, the next 48 hours matter. You need a clear diagnosis, honest answers about your options, and a surgeon who has performed this procedure many times.
At M&S Vascular and Orthopedic Group P.C. in Forest Hills, Queens, NY, Dr. Mehran Manouel specializes in orthopedic surgery and sports medicine, including anterior cruciate ligament (ACL) reconstruction. Patients from Commack, Babylon, Farmingdale, and surrounding communities regularly travel to our Queens office for knee care they trust.
This guide walks you through what an ACL tear really feels like, how we evaluate your knee, what surgery (if surgery) looks like, and how to make the right call for your recovery.
What Does an ACL Tear Actually Feel Like?
An ACL tear does not always announce itself with a dramatic pop, though many patients describe exactly that sound. Some feel a sudden give, as if the knee buckled under them. Others notice the joint locking, catching, or feeling "loose" when they try to pivot or change direction.
Swelling is one of the earliest and most common signs. It often peaks within 12 to 24 hours and can make the knee look visibly larger than the uninjured side. You may also struggle to bear full weight, and simple movements like descending stairs or getting out of a car become painful.
Not every ACL injury is a complete rupture. Partial tears and sprains exist on a spectrum, and the distinction matters because it changes your treatment path. That is why an in-person evaluation, rather than a guess, is the right first step.
How We Evaluate Your Knee in Forest Hills
When you arrive at our Forest Hills office, Dr. Manouel begins with a focused conversation: how the injury happened, what you felt in the moment, and how the knee has behaved since. He then performs a hands-on physical exam, including the Lachman test, anterior drawer test, and a pivot-shift maneuver to assess ligament stability.
Imaging is the next layer. An X-ray rules out a fracture or bone avulsion. An MRI gives us a detailed view of the ACL, the menisci, and surrounding soft tissue. In most cases, we review the MRI with you in the room so you can see exactly what is going on and ask questions in real time.
You leave the visit with a clear picture: the grade of your tear, whether other structures are involved, and a discussion of your options. There is no pressure to decide on the spot.
Your Treatment Options: Surgery vs. Conservative Care
Not every ACL tear requires reconstruction, and Dr. Manouel will be straightforward about that. If your tear is partial, your knee is stable, and your activity level does not demand high-speed pivoting, a structured non-surgical program may be appropriate. This typically involves targeted physical therapy focused on quadriceps and hamstring strengthening, proprioception drills, and a gradual return to activity over several months.
Surgical reconstruction becomes the more common recommendation when the tear is complete, the knee is unstable, or you participate in cutting, jumping, or rotational sports. It is also a realistic consideration if you want to return to a pre-injury level of athletic performance.
During your consultation, Dr. Manouel walks through both paths, the risks and benefits of each, and what a realistic timeline looks like. You are the one making the final call, and he supports that decision with information, not pressure.
What ACL Reconstruction Surgery Involves
ACL reconstruction is an arthroscopic procedure, meaning it is performed through small incisions with a camera and specialized instruments. Dr. Manouel typically uses a hamstring autograft (your own tendon tissue) or, in select cases, a patellar tendon or allograft. The graft is anchored into the femur and tibia with screws or interference devices to recreate the ACL's stabilizing function.
The surgery itself generally takes about 60 to 90 minutes. Most patients go home the same day or the next morning. You will leave the office with a hinged brace, crutches, and clear instructions on weight-bearing limits and wound care.
Dr. Manouel is board-certified in orthopedic surgery with a focused interest in sports medicine, and he performs these reconstructions regularly at our Queens practice. You will also have access to Dr. Amir Salem, our interventional radiology and vascular surgery specialist, should any circulatory or vascular considerations come up during your recovery.
Recovery Timeline: What to Expect Week by Week
The first two weeks are about protecting the graft. You will use crutches, keep the knee in a hinged brace, and attend early physical therapy sessions focused on reducing swelling, restoring full extension, and beginning gentle range-of-motion work.
Weeks three through six shift the focus to strengthening. You will progress to weight-bearing, stationary cycling, and controlled squats. By around month three, most patients are jogging and performing basic agility drills under a therapist's guidance.
Months four through six bring sport-specific training: cutting, pivoting, jumping, and return-to-sport testing. The full return to competitive athletics typically lands somewhere between nine and twelve months, though individual timelines vary. Dr. Manouel will see you at scheduled follow-ups to track healing on exam and, if needed, on imaging, and to clear you for each milestone.
How to Choose the Right Orthopedic Surgeon Near You
Volume matters. Look for a surgeon who performs a high number of ACL reconstructions each year and who is fellowship-trained in sports medicine. Dr. Manouel's practice in Forest Hills is built around orthopedic and sports medicine care, so knee ligament surgery is a core part of his work, not a side procedure.
Also consider logistics. You will need multiple follow-up visits and a physical therapy partnership over the next year. Choosing a surgeon whose office is convenient to your home or workplace, whether you are in Commack, Garden City, or further along the Island, makes that process far less stressful. Our Queens location is accessible from the Long Island Expressway, and we coordinate closely with local physical therapy clinics.
Finally, trust the conversation. A good surgeon will explain your options in plain language, answer every question, and make sure you feel informed before you sign anything.
Frequently Asked Questions About ACL Tears
Can I drive after ACL surgery?
Most patients can resume driving with a right-foot brake once they are off crutches and out of the hinged brace, usually around three to four weeks. Your surgeon will confirm readiness at a follow-up visit.
Will the graft tear again?
Re-tear rates are low but not zero, especially if the graft is stressed before it is fully integrated. Following your physical therapy protocol and delaying return to sport until cleared significantly reduces that risk.
Do I need a knee brace after surgery?
You will use a hinged brace for the first several weeks as directed by Dr. Manouel. After that, the brace is typically phased out as strength and stability return.
Can I get a second opinion before deciding on surgery?
Absolutely. We encourage it. Dr. Manouel will review your imaging and discuss findings openly, and you are welcome to bring outside records to our Queens office.
Take the Next Step
If you are in Commack, the surrounding Long Island area, or anywhere in the greater New York region and you are dealing with a suspected or confirmed ACL tear, you deserve a clear plan and a surgeon who will walk you through every step. Dr. Manouel and the team at M&S Vascular and Orthopedic Group P.C. are ready to help.
Call us at (718) 897-2228 to schedule an evaluation, or visit www.msorthovasc.com to learn more about our orthopedic and sports medicine services in Forest Hills, Queens, NY. We will get you the answers you need so you can make a confident decision about your knee.