Revision ACL Reconstruction

Revision ACL Surgery – An Overview
Revision ACL surgery is a procedure performed when a previous ACL reconstruction has failed due to graft rupture, improper placement, infection, or continued knee instability.
When is Revision ACL Needed?
Persistent knee instability after previous ACL surgery
Graft re-tear from trauma or early return to sports
Technical issues with previous tunnel placement
Stiffness or poor range of motion
Infection or graft failure
What Does the Surgery Involve?
Revision ACL surgery is more complex than the initial procedure. It may involve:
Removal of old hardware or graft
New tunnel creation if old tunnels are misaligned or widened
Bone grafting if previous tunnels need to be filled and healed first (in staged surgeries)
Selection of new graft (hamstring, patellar tendon, quadriceps, or allograft)
Is It a Single-Stage or Two-Stage Procedure?
Single-stage revision: If tunnels are intact and not malpositioned
Two-stage revision: If bone tunnels are too wide or malpositioned—bone grafting is done first, followed by ACL reconstruction after healing
Key Considerations
Requires precise planning with MRI and CT scans
Longer recovery and rehabilitation than primary ACL surgery
Outcome depends on cause of failure, surgical technique, and rehab compliance