Care areaKnee
Performed byWilliam Kel Vasileff, MD

The short answer

ACL revision is a second ACL surgery for a knee whose first reconstruction failed or re-tore. Dr. Vasileff performs it for people whose rebuilt ACL is loose or torn again and whose knee gives way. It is more complex than a first ACL surgery and is planned carefully.

William Kel Vasileff performs acl revision surgery in Columbus when it is the right step, and reviews every alternative with you first.

What is ACL revision, and who is it for?

ACL revision is a repeat surgery to rebuild an anterior cruciate ligament (ACL) that was reconstructed before and has failed, either because the graft re-tore or stretched out.

It is for people whose knee is unstable again after a first ACL reconstruction, with the kneecap-forward sense of the knee giving way during activity. Revision is more involved than a first ACL surgery because the old tunnels and graft have to be accounted for. A first-time ACL surgery is covered on the ACL reconstruction page.

What is tried before surgery?

Not every re-injured ACL needs revision right away.

Physical therapy rebuilds strength, and a brace and activity changes can settle the knee while it is assessed. Imaging checks the old graft, the tunnels, and any other damage. Revision becomes the right conversation when the knee keeps giving way despite this care. It is a planned surgery, not an emergency, and the plan is built from what the imaging shows.

**ACL Tear**Labeled medical illustration of acl tear Read more

How does ACL revision work?

The surgeon removes or works around the failed graft and rebuilds the ACL with a new graft, your own tissue or donor tissue, placed through tunnels in the bone.

Because tunnels already exist from the first surgery, revision sometimes needs extra steps, and in some cases is done in two stages, first filling old tunnels with bone graft and then rebuilding later. The work is done with arthroscopy, a small camera through tiny incisions.

What is recovery like after ACL revision?

Recovery follows a similar path to a first ACL surgery but is often more cautious.

The knee is protected early, then rebuilt through months of physical therapy focused on strength and control. Return to sport is commonly reported around nine to twelve months and can be longer after a revision, depending on the knee and any added procedures, according to general guidance from the American Academy of Orthopaedic Surgeons. These are ranges, not promises.

Read the full guide to preparing for surgery

Your own recovery instructions come from the office and are specific to you. This page describes the general course, not a plan to follow.

Training and credentials

Education and training

Medical school at Ohio State University College of Medicine, Columbus, OH, United States (Doctor of Medicine (MD)). Residency at Henry Ford Health System, Detroit, MI, United States. Fellowship at Henry Ford Health System, Detroit, MI, United States.

FellowshipHenry Ford Health System, Detroit, MI, United StatesOrthopaedic Surgery, Sports Medicine
ResidencyHenry Ford Health System, Detroit, MI, United StatesOrthopaedic Surgery
Medical schoolOhio State University College of Medicine, Columbus, OH, United States (Doctor of Medicine (MD))Doctor of Medicine
Board statusAmerican Board of Orthopaedic SurgeryBoard certified

What do patients ask most?

Why do some ACL reconstructions fail?

A rebuilt ACL can fail from a new injury, from the graft stretching over time, or from factors in the first surgery, and imaging helps sort out the cause before revision.

Is ACL revision harder than the first surgery?

It is more complex, because the surgeon has to account for the old graft and tunnels, and some knees need a two-stage approach.

How long is recovery from ACL revision?

Recovery runs several months and is often more cautious than a first ACL surgery, with return to sport commonly around nine to twelve months or longer.

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