I agree, no surgery if it was me

The ACL (anterior Wikipedia reference-linkcruciate ligament) is one of two "hidden" knee ligaments that attach the thigh (femur) to the lower leg (tibia) by "crossing" each other at the knee joint, hence the term "cruciates".

As the name suggests, the ACL attaches from anterior surface of the tibia, blends with the anterior horn of the lateral Wikipedia reference-linkmeniscus and travels backwards to attach to the posterior part of the medial surface of the femoral condyle (thigh bone). The PCL (posterior cruciate ligament) crosses the knee joint the opposite way and works with the ACL to hold the knee together when the joint is under load or tension. Injury to the ACL is much more common.

At an American Osteopaedic Sports Medicine Society meeting, Dr Bernard Bach presented an insightful discussion on the indications and contradictions for ACL (anterior cruciate ligament) surgery. He concluded with the old adage emphasized by Dr Jack Hughston years ago, "nothing is so bad that it can't be made worse by surgery". Implying that not all patients with ACL tears require surgery.

The ACL provides 86% of stability in anterior displacement and 30% to any medial displacement. However, rupturing the PCL is worse, as it provides 96% of stability to any posterior movement and 36% to lateral stress. As you have probably found, closed chain movements such as the squat and leg presses are fine. It's not until you attempt to perform some form of dynamic action that involves movement in all three dimensions that you have trouble. This is why many doctors and surgeons adopt a "wait and see" approach on ACLs before recommending surgery. Unless the patient regularly performs dynamic, open chain movements they see no need to operate.

With the correct rehabilitation strategies the hamstring muscles learn peripheral compensation and provide a great deal of anterior shift stability.

Seek out a local physio before you contemplate going under the 'knife'