This will be a retrospective chart and imaging review of the patients who have undergone this procedure since its inception. From the patient charts, we will collect demographic and surgical information. From their imaging, we will collect pre- and postoperative radiographic measures to assess whether adequate distalization has been achieved. Patients that have received this surgery and are willing to provide patient reported outcomes will be contacted and asked about post-operative pain, functionality, and satisfaction.

This study will evaluate whether using cold therapy before Anterior Cruciate Ligament (ACL) reconstruction surgery improves recovery during the first six weeks after surgery. Patients undergoing ACL reconstruction will either receive standard preoperative care or standard care plus a period of cold therapy prior to surgery. Pain levels, swelling, medication use, and functional recovery will be tracked using surveys and routine clinical follow-up information. participation will not change the surgical procedure or postoperative rehabilitation plan.