Many times if you re-injure your ACL, another reconstruction is needed. If this is the case, well over 50% of the time the reconstruction requires two surgeries. The first surgery requires Dr. Lowe to remove the old screws from the tunnels (figure 1), repair any damage that occurred to the other structures of the knee and to use donor bone plugs (figure 3) to graft into the tunnels (figure 2). After a sufficient period of time to allow for proper healing of the bone grafting, Dr. Lowe will then perform the second phase of the reconstruction. This surgery consists of drilling new tunnels and then reconstructing the ACL again.

In a few cases, Dr. Lowe is able to remove the hardware and use those tunnels to reconstruct the ACL. This is not a common occurrence since the stresses that tear the ligament also tend to widen out the tunnels. If the tunnels are too big, there is no way to secure the new graft properly and bone grafting will be required.
There will be a period of rehabilitation required after each surgery. Once the ACL reconstruction has been completed, another full course of rehabilitation to strengthen the knee will once again be required.

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