The failed ACL and other ligament reconstruction have many causes but in majority of the cases there will be technical error in the non-anatomic graft positioning. Some of the other common causes include:
1. Graft Impingement : Occurs due to the entrapment of the graft in the notch.
2. Failure of Fixation: Due to the weakest link which is the point of attachment
3. Intrinsic Graft Failure: Caused due to graft impingement or trauma.
4. Arthrofibrosis: Scar tissue is formed after injury or surgery causing decreased range of motion.
The doctors would first prepare the patient for surgery and then tiny incisions are created to help in Knee Arthroscopy. The knee is first evaluated and any scar tissue is removed. If the hardware placed earlier is blocking the way of the ideal tunnel placement, then it is removed.
Then doctor makes the tunnels in the right position and then passes the graft through the tunnel and fixes it with metal or bio absorbable implants.
The doctor will then remove the instruments and close the incision site. The whole surgery will be done by key hole technique, which has the advantages such as, of less pain, less blood loss, early recovery and short hospital stay.