A knee that gives way on the stairs, locks when you stand up, or swells after every pickup game is telling you something. Many knee problems settle with rest and therapy, but some involve torn ligaments, damaged cartilage, or an unstable kneecap that may not improve with time alone. Let’s walk through the knee conditions that may call for surgery and how we decide what your knee needs.
When Knee Pain Points to a Structural Problem
Your knee depends on bones, ligaments, cartilage, and tendons working together. Knee pain can begin without an injury, after a traumatic event, or from overuse, and not every condition requires surgery. Sometimes pain improves with rest, medication, injections, or physical therapy. Surgery enters the conversation when a structure is torn or unstable, when locking or giving way keeps returning, or when nonsurgical care has not restored the function you need.
Ligament Injuries That May Need Reconstruction
An ACL tear is one of the most common knee injuries, with more than 200,000 occurring in the United States each year.1 It often happens when you pivot, cut, or land from a jump. Whether you need surgery depends on factors such as the severity of the injury, your age, and your activity goals, and reconstruction remains the most common surgical treatment.1 ACL reconstruction replaces the torn ligament to restore stability to your knee. Injuries to other ligaments may call for PCL reconstruction, and when several ligaments tear at once, multiligament knee injuries often need a surgical plan tailored to each injured structure.
Meniscus Tears: Repair, Trim, or Replace
Your menisci are two wedge shaped pieces of fibrocartilage that absorb shock between your thighbone and shinbone.2 A tear in the outer third, which has a rich blood supply, may heal on its own or can often be repaired, while symptomatic tears in the inner two thirds cannot heal and are usually trimmed if they do not respond to conservative treatment.2 Meniscal repair surgery aims to save as much meniscus as possible. A meniscus root tear can leave the meniscus unable to protect the cartilage beneath it, and if a large portion of your meniscus has been removed or damaged beyond repair, meniscus transplantation may restore cushioning.
Kneecap Instability
If your kneecap slips out of its groove, you may feel it shift or give way with twisting. After a first dislocation, treatment is usually nonsurgical, with exercises and bracing.3 When patellar instability keeps returning, surgery such as medial patellofemoral ligament reconstruction may be recommended, and outcomes for these procedures are very good, with a redislocation rate of less than 10 percent.3
Cartilage Damage and Alignment Problems
Articular cartilage covers the ends of your bones, and because it does not heal itself well, surgical techniques have been developed to stimulate new cartilage growth.4 Depending on the size and location of the defect, knee cartilage restoration options include autologous chondrocyte implantation (MACI), which grows your own cartilage cells and implants them in the defect, and osteochondral allograft transplantation, which uses donor cartilage and bone for larger defects.4 If uneven alignment is overloading one side of your knee, a knee osteotomy reshapes the thighbone or shinbone to relieve pressure on the damaged area.
Tendon Ruptures
A tear of the quadriceps or patellar tendon can make it difficult or impossible to straighten your leg. Small partial tears may respond to immobilization and physical therapy, but complete tears require patellar and quadriceps tendon repair to reattach the tendon to the bone.
How Arthroscopy Fits Into Knee Surgery
Many of these procedures use knee arthroscopy, in which a small camera and thin instruments pass through tiny incisions. Common arthroscopic knee procedures include meniscus repair or trimming, ACL and PCL reconstruction, and treatment of damaged cartilage, and the small incisions mean less pain and stiffness than open surgery.5 If you are generally healthy, your knee arthroscopy will most likely be an outpatient procedure.5 At our Rockford and Elgin offices, we walk you through which approach fits your injury.
Frequently Asked Questions
How do I know if my knee injury needs surgery?
Your knee may need surgery if it locks, keeps giving way, or stays painful and swollen despite rest and therapy. An exam and imaging such as MRI help us identify which structure is injured and whether it can recover without an operation.2
Can a torn meniscus heal on its own?
Some meniscus tears can heal, depending on where they occur.2 Tears in the outer zone with good blood supply may heal or be repaired, while tears in the inner zone cannot heal and are trimmed if your symptoms persist.2
Do I need surgery for a torn ACL?
Not always, because the decision depends on the severity of your injury, your age, and your goals.1 If you want to return to cutting and pivoting sports, we often discuss reconstruction, the most common surgical treatment.1
What is recovery like after knee surgery?
Your recovery depends on the procedure, but physical therapy is central to almost every plan. Our rehabilitation protocols for procedures such as ACL reconstruction, meniscus repair, and MPFL reconstruction show you what to expect at each stage.
Where can I see a knee surgeon if I live in Crystal Lake?
If you live in Crystal Lake, you can see us at our Elgin office at 1550 N Randall Rd or our Rockford office at 324 Roxbury Rd. You can discuss your treatment options at either office.
Find the Right Plan for Your Knee
Knee surgery is one option among many, and the right choice depends on the exact problem inside your knee. Whether you are in Rockford, Elgin, or Crystal Lake, if your knee is limiting what you can do, you can schedule a knee evaluation or call (779) 774-1110 to begin the conversation.
References
- American Academy of Orthopaedic Surgeons. Anterior Cruciate Ligament (ACL) Injuries. OrthoInfo. Accessed November 6, 2026. https://orthoinfo.aaos.org/en/diseases--conditions/anterior-cruciate-ligament-acl-injuries/
- American Academy of Orthopaedic Surgeons. Meniscus Tears. OrthoInfo. Accessed November 6, 2026. https://orthoinfo.aaos.org/en/diseases--conditions/meniscus-tears/
- American Academy of Orthopaedic Surgeons. Patellar (Kneecap) Instability. OrthoInfo. Accessed November 6, 2026. https://orthoinfo.aaos.org/en/diseases--conditions/unstable-kneecap/
- American Academy of Orthopaedic Surgeons. Articular Cartilage Restoration. OrthoInfo. Accessed November 6, 2026. https://orthoinfo.aaos.org/en/treatment/articular-cartilage-restoration/
- American Academy of Orthopaedic Surgeons. Knee Arthroscopy. OrthoInfo. Accessed November 6, 2026. https://orthoinfo.aaos.org/en/treatment/knee-arthroscopy/
AUTHOR: Geoffrey Van Thiel, MD, MBA – Orthopedic Sports Medicine Surgeon
Geoffrey Van Thiel, MD, MBA is an orthopedic surgeon specializing in minimally invasive and arthroscopic surgery of the hip, knee, and shoulder. Widely recognized as a leader in orthopedic sports medicine, he has authored more than 100 peer-reviewed publications and delivered over 200 international presentations. His practice combines cutting-edge surgical innovation with compassionate, patient-centered care focused on restoring active lifestyles.
Credentials & Education
Dr. Van Thiel earned his medical degree from the University of California, Los Angeles (UCLA) School of Medicine and completed a Master of Business Administration at the UCLA School of Business. He completed his orthopedic surgery residency at Rush University Medical Center in Chicago, one of the nation’s top training programs. He remained at Rush to complete fellowship training in orthopedic sports medicine and hip arthroscopy and continues to serve on faculty, contributing to research and surgeon education.
Clinical Expertise
Dr. Van Thiel has collaborated with internationally recognized surgeons on advancements in hip arthroscopy, cartilage restoration, knee ligament reconstruction, and shoulder arthroscopy. He serves as a consultant for leading orthopedic device companies and frequently lectures and trains surgeons on innovative techniques. He is actively involved with the Multicenter Arthroscopic Study of the Hip (MASH), serves on editorial boards for major orthopedic journals, is a surgeon educator for AANA and AOSSM, and chairs the Outcomes Committee for OrthoForum.
Dr. Van Thiel believes that exceptional orthopedic care requires not only advanced technology and precision but also compassion and humility in every patient interaction.
Medical Disclaimer: This information is for educational purposes only and does not constitute medical advice. For diagnosis and treatment recommendations, please consult with Dr. Van Thiel or another qualified orthopedic specialist.
Content authored by Dr. Geoffrey Van Thiel and verified against official sources.
