A 21-year-old female lacrosse athlete with a prior left knee anterior cruciate ligament reconstruction sustained an acute, noncontact injury to the same knee during practice. Clinical examination showed adequate sagittal plane joint stability, with reduced rotational support. Radiologist’s findings following magnetic resonance imaging suggested an increased signal at the anterior cruciate ligament, presence of a subacute medial meniscus tear, and Grade II strain of the semimembranosus tendon. Surgical intervention included anterolateral ligament reconstruction and debridement. The clinical team used patient-reported outcome measures and symmetry of strength and balance to progress therapy. Although cleared for exercise, her National Collegiate Athletic Association (NCAA) eligibility expired and she never returned to sport.