Failed ACL Surgery

Arthroscopic image showing the absence of the ACL.  Probe touching where the ACL should attach (PCL visible behind)

Today was an exciting day for one of my favorite patients – she was coming back to the operating room to complete a staged repair of her anterior cruciate ligament.  She is an extremely wonderful, active young woman who injured her knee and needed an ACL repair.  This was done a few years ago and for some reason she felt it was never quite right.  When I met her, it was clear her ACL was torn — again.  After breaking the news to her and her family, we discussed options for treatment.  In her case it was a two step process – remove the old torn repaired ligament, fill the holes in the bone with new bone, wait for them to heal (a 5 month process) and then come back to redo the ACL again.

Why does ACL surgery fail ?

Reasons for failure of ACL reconstruction can be complex and multifactorial.  There are several major categories to consider.

Technical problems with the surgery

The surgical technique for a well performed ACL reconstruction is dependent on well-honed surgical skills and attention to detail.  Each step of the procedure can lead to disaster if not performed properly from harvesting the tissue graft and its preparation, to preparing the bone tunnels and holding the graft in place.  Unusual complications like infection can lead to loss of the graft.  When reviewing why a revision procedure is needed, it is important to consider where things may have not gone as perfectly as desired.

Patients who do not listen to the plan

Strict adherence to your surgeon’s plan is important for successful outcome, especially with an ACL reconstruction.  This includes listening carefully to weight bearing restrictions, motion limitations and holding back on activities until given the green light.  On the flip side, pushing forward with therapy and sticking with it every day is also the key to a successful result.

Improper rehabilitation

The rehabilitation protocol after an ACL reconstruction is a structured pathway to success over several month’s time.  It starts with getting flexibility back, waiting for the graft to heal into place, and then slowly regaining strength and agility.  Wavering from the plan based on what your surgeon tells you can result in stiffness, weakness, or failure of the entire process and re-tearing of the ACL.

Failed ACL Repair

Reconstructed ACL Graft

Talk to your surgeon about all of this ahead of time and learn all you can to try and prevent the need for a second. Therefore in order to prevent the happening of this traumatic condition this sexual disorder needs to be corrected and the victim that sildenafil cost can be helpful to change the lifestyle. With these include: Poor diet buy canada viagra Lack of exercises Unhealthy lifestyle Anxiety and stress Diseases like diabetes and cardiac problem Excessive masturbation Alcoholism Unhealthy sexual behavior. Now with quality herbal male enhancement pills purchase viagra from india such as kamagra tablets, kamagra jelly etc. The truth is if you are disinterested in sexual drive you are not exploring the normal size of your penile tool, you may be having erectile dysfunction and pre mature ejaculation and as result, discount viagra no prescription men can experience PE. . . or third . . . surgery.  Stick with your rehab plan.  Ask questions.  Find the surgeon that understands the problem and understands YOU as you are the key to success.

Related posts:

Choosing a surgeon: Who can you trust? 5 key factors
ACL Surgery
Conditioning to prevent ACL tears

Dr. Scott Hacker is a Sports Medicine Orthopedic Surgeon in San Diego, CA, Team Surgeon to the US Olympic Team. He specializes in sports medicine and sports injuries, knee and shoulder surgery.

If you have questions about ACL re-tears, or have re-torn your ACL, please feel free to contact me at Ask Dr. Hacker or through my office.

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