Choosing the Right ACL Surgeon

An evidence-based patient guide to choosing an ACL surgeon. Ochsner-Andrews Sports Medicine Institute and Dr. Jeremy Burnham serve Baton Rouge, South Louisiana, and the Gulf South.

Few orthopedic injuries shape an athlete’s career like a torn ACL. The decision of which surgeon performs the ACL reconstruction is, statistically and clinically, one of the most consequential choices a patient will make in the first weeks after the injury. That single decision shapes whether the patient returns to sport, whether the patient returns at the same level, whether the knee re-injures within 24 months, and whether early-onset osteoarthritis sets in a decade later.

This guide is written for patients who have been told they need an ACL reconstruction and want to choose carefully. It walks through the criteria that the published literature actually associates with better outcomes: surgeon specialization, surgical volume, individualized graft selection, evidence-based rehabilitation, return-to-sport criteria, and active engagement in clinical research. Each section ties back to peer-reviewed studies, including research from Dr. Jeremy Burnham and the team at the Ochsner-Andrews Sports Medicine Institute. The goal is not to argue that any single surgeon is the right answer; the goal is to help patients ask the right questions before they commit.

1. Why Choosing the Right ACL Surgeon Matters

The “right surgeon” decision is bigger than surgical technique alone. It encompasses graft selection, rehabilitation protocol, return-to-sport criteria, and long-term knee preservation strategy. Each of these elements affects re-tear risk, functional outcomes, and the probability of returning to the same level of sport.

A New York State analysis of 77,899 ACL reconstructions performed by 1,316 surgeons between 2003 and 2014 found that surgeons performing more than 35 ACL reconstructions per year had a 29% lower risk of subsequent ipsilateral knee surgery than those performing fewer than 17 per year (HR 1.29, 95% CI 1.23 to 1.35, p<0.001) [1]. Even surgeons in the middle volume tier (18 to 35 cases per year) showed a 6% reduction in subsequent surgery risk relative to the lowest-volume group. The volume-outcome relationship is well established across orthopedic procedures, and ACL reconstruction is no exception.

At the Ochsner-Andrews Sports Medicine Institute, ACL reconstruction is a primary clinical and research focus. Patients are managed by a multidisciplinary team that includes the orthopedic surgeon, sports physical therapists, athletic trainers, strength and conditioning coaches, and a coordinator dedicated to the ACL Center of Excellence. The volume-outcome literature, combined with team continuity across surgery and rehabilitation, has measurable downstream effects on what matters most to patients: returning safely to the activities they love.

2. Specialization in Sports Medicine and ACL Surgery

Not every orthopedic surgeon performs ACL reconstruction. Within the surgeons who do, a subset has formal sports medicine fellowship training, and a smaller subset focuses on knee ligament reconstruction at academic depth. Patients should ask three questions:

1. Did the surgeon complete an ACGME-accredited sports medicine fellowship?
2. What proportion of the surgeon’s clinical practice is dedicated to knee ligament reconstruction?
3. Is the surgeon board-certified in orthopedic surgery and subspecialty-certified in sports medicine?

Dr. Jeremy Burnham completed his orthopedic surgery residency at the University of Kentucky, training under Dr. Darren Johnson, one of the highest-volume ACL surgeons in the United States, head team orthopedic surgeon for University of Kentucky Football, and the SEC Team Physician of the Year in 2013, alongside Dr. Mary Lloyd Ireland and Dr. Christian Lattermann. He then completed a sports medicine fellowship at the University of Pittsburgh Medical Center under the late Dr. Freddie Fu, a pioneer of anatomic ACL reconstruction whose framework reshaped how the procedure is performed worldwide [2]. He also trained under Dr. Volker Musahl, an internationally recognized ACL surgeon and researcher, and Dr. James Bradley, the longtime head team physician for the Pittsburgh Steelers. UPMC is widely recognized as a center of academic excellence in anatomic ACL reconstruction.

Dr. Burnham is board-certified by the American Board of Orthopaedic Surgery and holds subspecialty certification in sports medicine. He has authored 53 peer-reviewed publications and 13 book chapters on orthopedic and sports medicine topics, the majority focused on ACL reconstruction, biomechanics, and return-to-sport. He is the most published ACL surgeon in Louisiana and serves on the AOSSM BOLD Leadership Cohort, a national leadership development program. View the full publication list and clinical-trial portfolio.

3. Volume and Experience

ACL volume is one input. Experience across the patient spectrum is another. A surgeon who reconstructs ACLs in adolescent club soccer players is making a different set of clinical judgments than one who reconstructs ACLs in collegiate football linemen, and a different set again than one who handles revision (second-surgery) reconstructions or reconstructions in patients with prior ipsilateral knee surgery.

Dr. Burnham performs ACL reconstructions across the full spectrum: youth and adolescent athletes, high school competitors, collegiate athletes, professional athletes, recreational and weekend competitors, and revision and complex multiligament reconstructions. His team-physician roles add hands-on context. During fellowship in Pittsburgh, he served alongside the team physician staff for the University of Pittsburgh, Carnegie Mellon, and several professional sports organizations. In Baton Rouge, he serves as a team physician for the Baton Rouge Rougarou, Parkview Baptist, Central High School, Brusly High School, St. Thomas Aquinas in Hammond, and is an Official Sports Medicine Provider to the LHSAA.

Volume and breadth, combined, mean that the surgeon a patient meets has likely seen presentations very similar to theirs many times before. That pattern recognition is a quiet but real driver of better surgical decision-making.

4. Personalized Treatment Plans and Graft Selection

ACL graft choice is one of the most important surgical decisions after the decision to reconstruct at all. The four primary autograft and allograft options are quadriceps tendon (QT), bone-patellar tendon-bone (BTB), hamstring tendon (HT), and allograft. Each option has distinct biomechanical properties, harvest morbidity profiles, healing characteristics, and re-tear risk profiles that depend on the patient’s age, sport, sex, prior surgical history, and recovery goals.

Bone-patellar tendon-bone has been a gold-standard autograft for more than 30 years, with the longest published track record and excellent outcomes for high-demand pivoting athletes. Quadriceps tendon has emerged in recent years as a robust autograft option, particularly for patients with concerns about anterior knee pain or kneeling discomfort. Hamstring autograft offers low harvest-site morbidity but requires careful candidate selection: large registry data have shown meaningfully higher revision rates after hamstring autograft in younger and adolescent athletes, with one Swedish National Knee Ligament Registry analysis reporting roughly twice the revision rate in adolescents compared with young adults [11]. Allograft is generally reserved for older recreational patients or specific revision scenarios; the multicenter MOON cohort showed allograft is associated with higher revision rates than autograft in younger active patients [3].

Dr. Burnham has authored published research on quadriceps tendon, hamstring, and patellar tendon graft outcomes [4][5] and has co-authored book chapters on individualized anatomic graft selection [6][7]. The Ochsner-Andrews approach is patient-specific: graft choice is driven by a structured conversation that weighs sport, age, contralateral graft history, prior surgical history, anatomy, and the patient’s recovery goals. There is no single best graft, only the right graft for the right patient. For a deeper comparison of the major options, see the article on ACL graft options compared.

5. Focus on Rehabilitation and Return-to-Sport Criteria

Surgery is one chapter. Rehabilitation determines whether the patient returns to sport safely, whether the graft holds, and whether the second knee stays healthy. Patients should ask: what is the surgeon’s rehabilitation protocol, who supervises it, what are the return-to-sport criteria, and how are those criteria measured?

The Delaware-Oslo ACL cohort study by Grindem and colleagues demonstrated that simple decision rules, specifically passing a battery of strength and hop tests plus delaying return to sport until at least 9 months postoperatively, reduced re-injury risk by 84% [8]. For each month return to sport was delayed up to 9 months, re-injury risk dropped further. The implication is direct: the timeline matters, the criteria matter, and the surgeon must hold both.

The Ochsner-Andrews ACL Center of Excellence runs an evidence-based rehabilitation protocol coordinated by Luke Bunch, DPT, and supervised by Dr. Burnham. Patients have on-site access to the Elite Training Complex, which is equipped with markerless motion capture, flush-mounted force plates, and 1080 Sprint resistance technology. These tools allow the team to measure quadriceps strength, single-leg hop performance, sprint mechanics, and limb-symmetry indices objectively rather than relying on a clock or a subjective patient report.

Return-to-sport criteria at the Center of Excellence follow a phased approach known as the 70/80/95 method: a 70% limb-symmetry index gates a return to running, 80% gates a return to cutting and agility work, and 95% gates a return to full competition. This approach aligns with international consensus on ACL rehabilitation [9] and adds objective, measurable thresholds at each transition rather than discharging patients on a fixed time-since-surgery basis. The detailed milestone map is laid out in the week-by-week ACL recovery guide, and patients searching more broadly for a Baton Rouge knee doctor can review how the Ochsner-Andrews team approaches the broader knee preservation pathway.

Alexis Rodriguez, basketball player at Family Christian High School, on her ACL reconstruction recovery and return to sport at the Ochsner-Andrews Sports Medicine Institute.

6. Communication, Patient Education, and Shared Decision-Making

A surgeon who explains the diagnosis, the surgical options, the graft trade-offs, the realistic recovery timeline, and the risks in language the patient understands gives that patient the foundation to make an informed decision. Patients should never feel rushed, talked over, or pressured into a specific procedure on the first visit.

The Ochsner-Andrews Sports Medicine Institute prioritizes patient education from the first consultation. Conservative-first framing matters: not every ACL tear demands immediate surgery, and not every knee with mechanical instability has a torn ACL. The surgical team’s job is to walk every patient through the same evidence base it uses internally, then make a recommendation tailored to that patient’s anatomy, goals, and clinical picture.

The site’s patient-education library is part of that commitment to shared decision-making. Patients who want to understand what ACL tear symptoms feel like, whether walking on a torn ACL is safe, what before-and-after imaging actually shows, how long ACL surgery takes, and the week-by-week recovery timeline can find structured, peer-reviewed answers before their visit, then arrive with the questions that matter most to them.

7. Technology, Surgical Techniques, and Active Research

Modern ACL reconstruction is performed arthroscopically with anatomic tunnel placement, individualized graft fixation, and increasingly sophisticated biologic adjuncts. The surgical technique itself has evolved. Anatomic ACL reconstruction, the framework developed at UPMC under Dr. Freddie Fu, prioritizes reproducing each patient’s native ACL footprint dimensions rather than using a one-size-fits-all tunnel position [2]. Tunnel placement at the anatomic footprint is associated with better rotational stability and improved long-term outcomes. Patients who want a closer look at how the operation is performed today can review the ACL reconstruction surgery overview, and patients with partial tears who are candidates for primary repair can read about the BEAR implant ACL repair.

Active research participation is a marker that a surgeon is engaged with the cutting edge of the field rather than simply executing protocols developed elsewhere. Dr. Burnham serves as Site Principal Investigator for two federally funded ACL clinical trials:

• The NIH-funded STABILITY 2 Trial (NCT03935750), evaluating whether adding a lateral extra-articular tenodesis to ACL reconstruction reduces graft failure in young active patients.
• The Department of Defense-funded STaR Trial (NCT03543098), comparing autograft choices in active-duty military and athletic populations.

He is also Principal Investigator on a single-center randomized controlled trial evaluating biologic augmentation of the quadriceps tendon harvest site during ACL reconstruction, funded jointly by the AOSSM Playmaker Award and an Arthrex Global Research Grant [10]. More on that work is available on the amnion ACL reconstruction page.

This research footprint matters to patients in three ways. First, surgeons who participate in clinical trials operate at the standard of care recognized by national funding bodies. Second, eligible patients may have the opportunity to enroll in trials and receive trial-quality follow-up. Third, the surgical techniques and rehabilitation protocols used in research-active centers are continuously updated based on the data being generated.

8. Importance of Second Opinions and Informed Choices

ACL reconstruction is a one-time decision for most patients, and its consequences play out over years. Patients are encouraged to seek second opinions, ask questions, and feel comfortable interviewing more than one surgeon before scheduling.

The Ochsner-Andrews Sports Medicine Institute welcomes second-opinion consultations. The expectation is not that every patient who walks in chooses to schedule with Dr. Burnham; the expectation is that every patient who walks out leaves with a clearer understanding of the diagnosis, the realistic outcome range for the major treatment options, and the criteria by which any surgeon should be evaluated. Patients who have been told they need an ACL reconstruction and want a second perspective from a fellowship-trained, high-volume ACL surgeon can request a consultation here.

9. Why Patients Choose Dr. Burnham for ACL Reconstruction

Patients across Baton Rouge, Prairieville, Gonzales, Denham Springs, Walker, Zachary, Brusly, Hammond, Covington, Mandeville, New Orleans, and the surrounding South Louisiana communities choose Dr. Burnham for ACL reconstruction because the criteria laid out in this article align with the way the Ochsner-Andrews Sports Medicine Institute is built.

Dr. Burnham is the most published ACL surgeon in Louisiana, with 53 peer-reviewed publications and 13 book chapters across journals including the American Journal of Sports Medicine, Arthroscopy, Knee Surgery, Sports Traumatology, Arthroscopy, the Journal of ISAKOS, and the Orthopaedic Journal of Sports Medicine. His ACL injury prevention research has been recognized with the Game Changer Award from the Arthritis Foundation, and his biologic augmentation work received the Playmaker Award from the American Orthopaedic Society for Sports Medicine. He is a Castle Connolly Top Doctor and a current member of the AOSSM BOLD Leadership Cohort. Patient success stories from across the practice illustrate what return-to-sport actually looks like for the patients who go through this pathway.

The infrastructure around the surgery, including a dedicated ACL Center of Excellence coordinator, an evidence-based rehabilitation protocol with objective return-to-sport gating, on-site biomechanical assessment at the Elite Training Complex, and active enrollment in NIH and Department of Defense ACL clinical trials, is what turns a single surgical event into a structured, measurable, multi-month return-to-sport pathway.

References

1. Schairer WW, Marx RG, Dempsey B, Ge Y, Lyman S. The Relation Between Volume of ACL Reconstruction and Future Knee Surgery. Orthopaedic Journal of Sports Medicine. 2017;5(7 Suppl 6):2325967117S00298. DOI: 10.1177/2325967117S00298. PMC: PMC5542339.
2. Burnham JM, et al. Anatomic ACL reconstruction. Annals of Joint. 2017;2:29. DOI: 10.21037/aoj.2017.05.10.
3. Kaeding CC, Aros B, Pedroza A, et al. Allograft versus Autograft Anterior Cruciate Ligament Reconstruction: Predictors of Failure from a MOON Prospective Longitudinal Cohort. Sports Health. 2011;3(1):73-81. DOI: 10.1177/1941738110386185. PMID: 23015994.
4. Hughes JD, Burnham JM, Hirsh A, Musahl V, Fu FH, Irrgang JJ, Lynch AD. Comparison of Short-term Biodex Results After Anatomic Anterior Cruciate Ligament Reconstruction Among 3 Autografts. Orthopaedic Journal of Sports Medicine. 2019;7(5):2325967119847630. DOI: 10.1177/2325967119847630. PMID: 31211150.
5. Diermeier T, Meredith SJ, Irrgang JJ, et al. (incl. Burnham JM). Patient-Reported and Quantitative Outcomes of Anatomic Anterior Cruciate Ligament Reconstruction With Hamstring Tendon Autografts. Orthopaedic Journal of Sports Medicine. 2020;8(7):2325967120926159. DOI: 10.1177/2325967120926159. PMID: 32685564.
6. Pratt KA, Burnham JM. ACL Reconstruction: Bone Tunnels, Graft Choice, and Fixation. Book chapter, 2023.
7. Kowalczuk M, Burnham JM, Albers M, Fu FH. Chapter 31: Individualized Anatomic Approach to ACL Reconstruction. In: ACL Masters. 2017.
8. Grindem H, Snyder-Mackler L, Moksnes H, Engebretsen L, Risberg MA. Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study. British Journal of Sports Medicine. 2016;50(13):804-808. DOI: 10.1136/bjsports-2016-096031. PMID: 27162233.
9. van Melick N, van Cingel REH, Brooijmans F, et al. Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus. British Journal of Sports Medicine. 2016;50(24):1506-1515. DOI: 10.1136/bjsports-2015-095898. PMID: 27539507.
10. Drazick AT, Aminake G, Howard E, Vieider R, Knighton S, Hughes J, Burnham JM. Placental-derived Membrane Augmentation During Anterior Cruciate Ligament Reconstruction: A Systematic Review of Limited and Heterogeneous Clinical Evidence. 2025 (submitted).
11. Thorolfsson B, Svantesson E, Snaebjornsson T, Sansone M, Karlsson J, Samuelsson K, Senorski EH. Adolescents Have Twice the Revision Rate of Young Adults After ACL Reconstruction With Hamstring Tendon Autograft: A Study From the Swedish National Knee Ligament Registry. Orthopaedic Journal of Sports Medicine. 2021. DOI: 10.1177/23259671211038893. PMC: PMC8516395.

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