ACL Revision Surgery - The Keys To Getting it Right

For those who did not have a successful primary ACL surgery, a revision ACL surgery is required. The original surgery usually fails due to issues beyond just the ACL. Outlining and addressing all issues within the knee is critical to a positive surgical outcome, especially in a revision setting. At The Stone Clinic, we assess the totality of the knee to make sure your knee is put in the best position possible for your graft to heal and allow you to return to your favorite activities, Fitter, Faster & Stronger than you were before your first surgery.

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AUTO TRANSCRIPT:
ACL tears and ACL surgery. Fortunately, most of the time works out quite well. However, in a number of cases, the ACL reconstruction or repair fails. And in that setting, we can rebuild the ACL using stronger donor tissue now from the quadriceps tendon. And we can understand their reasons for the failure, which most commonly are either misplacement of the first ligament or failure to understand the other ligaments and other tissues around the knee that are also damaged. And so today, whenever we do a revision reconstruction or rebuild a knee that has had a previous failed surgery, we're almost always combining it with what's called a lateral extra-articular reconstruction, where we add tissue on the side of the knee to diminish the excess rotation and stabilize the joint to help that new ACL have a more successful outcome. So to summarize, there's basically two major reasons that we see for ACLS to fail.

One is misplacement of the first graft. Two is a misunderstanding of all the injuries that occur around the knee when the ACL is torn. Often the side ligaments in the side tissues are stretched out as well. And so we think that combining an understanding of anatomic ACL reconstruction with an understanding of how to repair all the other tissues leads to a much greater success level for a c l surgery. So here, at The Stone Clinic, we believe that any knee surgery, and especially ACL reconstruction, needs to be combined with world-class physical therapy and fitness training. We help our patients see themselves as athletes in training, not patients in rehab. And so the rehab starts immediately on day one, where our patients will spend two hours a day where our physical therapy and fitness team, usually about an hour of soft tissue work and joint mobilization, and an hour of fitness training. This combination of immediate physical therapy and fitness training helps all of the knee injuries heal better and helps the patient see themselves as an athlete in training and not a patient in rehab.