Page ContentSingle Stage ACL RevisionDuring this procedure, the decision has been made to revise the failed ACL reconstruction in a single stage. The initial graft is removed through arthroscopy and debridement, and the hardware is removed from the femoral and tibial tunnels.Sometimes, the femoral tunnel was drilled in a different position than that chosen by your current orthopedic surgeon and the hardware doesn’t have to be removed (as it’s not in the way). If the femoral doesn’t need to be re-drilled, your surgeon will evaluate tunnel size.A decision will be made whether to proceed with a single stage revision or delay and perform a staged revision. The decision is based on tunnel size. Sometimes, the tunnel can widen because of contact stresses or during the process of hardware removal. If the tunnel is too large, adequate fixation of the new graft is difficult. Therefore, bone grafting may be required and a staged revision reconstruction will be recommended.Revision ACL reconstruction often requires increased time for graft incorporation and healing within the tunnels. Therefore, most patients are placed on the delayed ACL rehabilitation protocol with some modifications. Your weight-bearing status, range of motion allowed and level of activity will be determined on an individual basis.While we strive to obtain the best results, the knee is always vulnerable to recurrent injury or re-tearing. However, with good graft selection, sound technique and appropriate postoperative rehabilitation, we hope to minimize the need for further surgery.