Thomas Skalley, MD, an orthopedic surgeon with The Everett Clinic discusses Anterior cruciate ligament (ACL) surgery. Anterior cruciate ligament (ACL) injuries are common to sports with cutting a twisting. The first step in treatment is knowing if there are other issues including meniscus, cartilage or other ligament injuries. It can be corrected by establishing a treatment plan based upon situation and age. Not all ACL injuries require surgery.