I think one of the most important things to consider regarding whether to have surgery or not to have surgery for your ACL (anterior cruciate ligament) knee injury is your activity level. If you're involved in a lot of sports that involve jumping, such as volleyball or basketball — or what we call deceleration or cutting and pivoting, like soccer, where you change directions rapidly — you may be best served by seriously considering ACL reconstruction. If you participate in those sports without reconstruction, you may be at risk of instability episodes or give-way episodes of the knee. These episodes can damage the cartilage. If you are not involved in sports that require jumping or pivoting or cutting and desire to pursue sports like bicycling or swimming, which are mainly low impact, you may be well served by a nonoperative rehabilitation program.