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Re-torn ACL

Question: Re-torn ACL

Ten years ago when I was in high school I tore my ACLs in both knees (each one year apart) and now, just the other week, I re-tore my right knee. I have lined up meetings with a few surgeons at the Hospital For Special Surgery for the following month but in the mean time, would anyone know how a re-tear is repaired? Are there additional complications due to it being a graft tear? Has this happened to you?

Thank you!

Answer:

Now, I may be wrong, but I'm pretty sure that when I tore mine 20 years sgo, they said that if I re-tore it then they'd just use a different muscle to re-fix it (they used the patella tendon for the original repair, and would therefore use the hamstring for a second repair if needed.)

You should try to find and see a sports therapist near you, as they will advise you how to keep the muscle strength in your quads to stop/treat any imbalances there before the op, and afterwards, to make sure that any return to sport/activity is as safe as can be.

Muscle imbalance or a muscle that isn't working effectively (thus other muscles compensating for it) are a major cause of injury/re-injury.

Answer:

Since the patellar tendon has been used in both knees, this is no longer an option. Hamstring tendons are commonly used as grafts during ACL reconstruction with good results. Some surgeons are using the quadriceps tendon, though there is not a great deal of data available on this, as it is fairly new. I don't know if any os the sports surgeons at HSS are using this graft. Another option is an allograft - graft from a cadaver. This is has a better record in patients over 30 yrs of age and functions quite well; there is no pain from a donor site for the graft.
The only issues that may arise from the initial injury could be due to the possible development of arthritis. If there were any complications during the first surgery, this can make a repeat procedure more difficult.
While awaiting your appointment, make sure that you work on knee motion (bend and straighten as close to normal as possible) and leg strength with exercises such as leg raises.