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I tore my ACL a few years ago and got surgery over a year later. I can give you my impressions.
The doctors told me that completely torn ACLs do not heal on their own. I believe I read that partial tears do heal a bit. But my layman's interpretation of "heal" here is that you want the tendon to perform the same function as before, in terms of durability, strength, etc. A severe injury is hard to bounce back from in those regards, when it's really hard to train or gauge tendon strength.
It's not surprising that your friend regained his leg strength and then some. Once the collateral damage of an ACL injury heals (soft tissue or other) there is nothing hindering strength except the break in training. Closed chain movements like squats are particularly safe. The ACL shouldn't have much to do with it.
Stability is also trainable. The muscles in the leg can be trained, along with balance and proprioception, to become very stable. It is just a matter of training good movement patterns (true with or without surgery). My assumption for myself is that I had a lot of poor movement patterns that led to the injury in the first place. Stuff like balancing on one leg, single leg squats, were very useful in my recovery. Then you can get into dynamic movements like jumping and running.
The real tricky consideration is that your friend is a professional athlete in a relatively injurious sport. That goes far beyond training in a gym. You are dealing with open chain exercises and the added chaos of a competitive sport with other players. I'm sure your friend is aware via doctors, but the most difficult movements after a hurt knee are things like jumping and cutting, where there are higher forces and changes in direction. Add in the intensity of competition (which is where most athletes are injured) and I personally became more interested in surgery as an option.
The biggest factor for me was psychological. I did not want to second guess how my knee would perform under pressure, or risk further injuries like miniscus tears. Truth be told, I bet a lot of athletes could get away with no surgery (it's not unheard of), but if you are dealing with a drop in performance or durability I'm not sure it is worth the risk at that level. But I can also understand wanting to limit recovery time, especially if a surgery date is relatively far away (and the surgery does suck to recover from, arguably worse than the injury) or expensive (mine was free here). My doctor heavily encouraged anyone younger than 35 or involved in high-risk sports (like soccer) to opt for the surgery.
The surgery isn't fool proof but I would guess it does help (my leg feels rock solid now). But your friend will have to weight the risks and rewards of the options. I would say my leg felt 80-90% better in weightlifting and everyday use just before I got my surgery, but I did not get back into sprints or intense dynamic activities until after surgery.
Interesting, this was really helpful and comprehensive, thanks for your perspective!
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