Some ACL revision reconstruction surgeries require a double-stage or a two-stage process.

First Stage
During the first stage of a double-stage ACL revision reconstruction, the failed ACL graft is debrided and removed.  With the graft removed, a clearer perspective of the existing hardware can be viewed arthroscopically.  Then the existing hardware is removed.  Removing this hardware might leave holes in the bone that are too loose and/or too wide for the new screws to securely fixate the new graft in the second reconstruction.  Under these circumstances a bone grafting process is necessary in order for the fixation tunnels to heal to accommodate the revision graft.  The bone grafting allows the widened holes from the prior ACL surgery to be filled so that when the revision reconstruction is performed the screws have a tight, proper fit.

The patient at this point must attend physical therapy to achieve post-operative goals of regaining strength and returning to full motion.

Second Stage

The second stage of the double-stage ACL revision reconstruction is reconstructing the ACL with a new graft.  This second phase is usually performed approximately three months after the first stage.  This duration may be modified as deemed appropriately by Dr. Lowe.