An ACL tear (anterior cruciate ligament injury) can cause an athlete’s knee to either give out or feel unstable when they make certain movements, such as pivoting on a leg. Unfortunately, this kind of injury is all too common in sports like basketball, soccer, softball, football, and skiing, among others. Given the potential impact of an ACL tear, it’s something that athletes fear because it can significantly limit their ability to perform. While an ACL tear may not prevent participation in a sport altogether, it can diminish an athlete’s capabilities.

ACL Reconstruction Surgery

Since ACL tears are so common, athletes in high school and college often opt for ACL reconstruction surgery as a proactive way to address the issue. ACL reconstruction can stabilize your knee joint by making a new ligament. While effective, this type of surgery does not restore the ligament that’s been damaged, instead, it uses other tissue from your leg to develop a new ligament. Usually, the hamstring tendon or patellar tendon is used to create the new ligament.

When athletes have ACL reconstruction surgery, they must complete the required rehabilitation before returning to normal activities. In most instances, the surgery is a success and rehabilitation works out well. Which begs the question, can you tear your ACL again after surgery? Unfortunately, the answer is yes because there is a chance that complications can arise. In fact, you can re-tear the new ligament.

Ways You can Re-Tear Your ACL

There are a variety of ways to re-tear your ACL after you’ve had surgery and completed rehabilitation. But first, it’s important to understand why an ACL re-tear can occur in the first place. Whether the problem is related to the surgical procedure, issues with recovery, or something unique to your situation, being aware of potential problems can help you prevent them.

Possible Issues with Surgery

The positioning of the graft inside the knee joint is a factor that can dictate ACL surgery success, and precision is a key factor. Since the graft restores function to the normal ligament, it must be positioned in a manner that’s similar to the normal ligament. Failure to properly position the graft can cause abnormal joint mechanics, which can result in re-injury.

You may want to consider new techniques used to restore ACL anatomy or a new surgeon with more experience. For instance, another surgeon might choose larger grafts that tend to be more durable than smaller grafts. They may also choose an autograft, which is the use of your own tissue, instead of an allograft, which is donor tissue.

Challenges with Recovery

In order to ensure the new graft becomes part of your knee, proper rehabilitation is critical. The goal is to protect your knee and restore normal muscle strength. Depending on the type of graft used, it might be necessary to protect your knee for a period of six to nine months – allograft takes longer than autograft. The reason why this amount of time is required is because an implant holds the graft in place so that your body can incorporate the tissue as it becomes part of your new ACL. Engaging in too many activities can impede this process.

Another critical factor involved in preventing re-injury to your ACL is addressing any issues with neuromuscular weakness, which could have very well been the cause of the problem in the first place. Some athletes have good neuromuscular control with strength and stability in their body, while others do not. Correcting any issues with neuromuscular control can mitigate the possibility of re-injury.

Patient-Specific Factors

There are some factors related to the risk of re-tear after ACL surgery that are outside of your control, such as gender and age. For instance, it’s understood that female athletes and younger athletes are more prone to re-injury. Subsequently, your surgeon and therapist must consider any factors that are specific to your situation when developing a plan of care.

So, can you tear your ACL again after surgery? Yes, but there are ways to prevent this from occurring, and you should consider all of the ways discussed.

The best way to prevent ACL re-tearing is to choose a highly skilled surgeon like Dr. Hackett for your procedure. He can successfully repair the ACL and discuss ways to prevent a future tear.