CAUSES
- Re-tear of ACL
- Technical Failure of ACL reconstruction surgery
- Biologic failure of graft to heal
PREOP
- X-ray
- MRI Scan-Evaluate ACL, meniscus, cartilage, and other ligaments
- CT scan: evaluate ACL tunnel size and position
GRAFT CHOICES
- Dependent on previous graft used and age/activity level of patient
- Choices include BTB, Quad, Hamstring, Allograft, and even a graft from the other knee
RECOVERY
- 10 days suture removal
- 2-3 weeks brace and crutches
- 4-6 months physical therapy 2 x per week.
- Limp gone at 6-8 weeks
- Alter G running 12 weeks
- Running 4 months
- Cutting 6 months
- Return to Sport 9-12 months depending on cutting mechanics and strength
- Expectation is excellent range of motion and minimal to no pain
DAY OF SURGERY
- General and local anesthesia
- 2 hour surgery
- Outpatient
TECHNIQUE
- Depends on tunnel position
- Adequately positioned tunnels are re-used
- Suboptimal tunnels are bypassed or filled in
- Occasionally widened tunnels will require a two stage surgery
ADJUNCT PROCEDURES
- Dr. Gamradt may recommend a Lemaire Iliotibial band tenodesis or Anterolateral ligament reconstruction to augment the procedure and decrease the chances of another revision
SUCCESS RATE
- Less than primary ACL reconstruction
- Depends often on meniscus and cartlage status.
-
Torn ACL Graft
-
Revision Quad Graft
Questions?
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