Revision ACL Reconstruction

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Revision ACL Reconstruction Overview

Located in the front of the knee joint, the anterior cruciate ligament (ACL) provides stability to the joint during knee motion. The ligament plays an important role in preventing the femur (thighbone) from moving too far forward in relation to the tibia (shinbone). The ACL is the most commonly torn ligament in the knee and usually associated with sports. Most ACL tears in young active patients require surgical reconstruction since it does not heal well on its own. While ACL reconstruction is very successful, some Santa Barbara, Goleta, Santa Maria and Ventura, California patients may have persistent instability or re-tear their reconstructed ACL.  Dr. Jervis Yau, orthopedic knee surgeon, is highly experienced in ACL reconstructions and specializes in revision ACL surgeries.

“Failed” ACL reconstruction leads to instability and can occur from re-tear of the ACL graft due to subsequent injury, stretching out of the graft, or improper placement of the graft during the index procedure.   Of these, the most common cause of failure is due to a poorly positioned graft.  Patients with persistent knee dysfunction and instability due to ACL failure will benefit from revision surgery.

A complete medical review, physical examination and diagnostic imaging will help determine the exact cause of ACL failure in order to determine the optimal treatment plan.  It is important to note that even though revision ACL reconstruction is highly successful, it is technically more challenging and therefore, carries a higher complication rate.  Occasionally, more than one surgery may be staged in order to fill the previous ACL bone tunnels to ensure adequate fixation at the time of new graft insertion.

Dr. Yau strives to perform the revision ACL reconstruction in a timely fashion. He will determine the optimal graft choice after careful consideration of what was performed during the initial surgery.  Graft choices include autograft (from the patient) or allograft (from a donor).  If a staged procedure is necessary, Dr. Yau will perform a diagnostic knee arthroscopy of the knee and fill the previously drilled bone tunnels with bone graft.  Revision ACL reconstruction will then be performed approximately 3 months later to ensure adequate bone fixation of the newly placed graft.

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Recovery and Rehabilitation Following Revision ACL Reconstruction

Recovery after revision ACL reconstruction will typically take a longer than primary ACL reconstruction due to the complexity of revision surgery. Patients will be placed in a brace with protected weight bearing and crutches for a minimum of 2 weeks to help protect the newly reconstructed ligament. Physical therapy rehabilitation program will be prescribed and must be followed for optimal outcome. A functional brace may be used for up to one year following surgery when the patient is involved in sports. Generally, most patients should expect a 6 to 12 month recovery process.

For additional resources on knee revision surgery, such as a revision ACL reconstruction, please contact the Santa Barbara, Goleta, Santa Maria and Ventura, California orthopedic office of knee surgeon Dr. Jervis Yau.

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