Revision ACL Reconstruction
A complex arthroscopic procedure to replace a failed ACL graft and restore knee stability — when a previous reconstruction has not healed correctly or the graft has re-torn.
What is Revision ACL Reconstruction?
Revision ACL reconstruction is performed when a previous ACL reconstruction fails — due to graft failure, reinjury, tunnel malposition, or incomplete healing — leaving the patient with persistent knee instability, pain, and difficulty with daily activities or sport. This procedure is significantly more complex than primary reconstruction. It requires careful pre-operative planning, imaging analysis of the previous tunnels, and selection of the most appropriate new graft source to give the patient the best chance of a lasting result.
SUITABLE FOR Patients with persistent knee instability, giving-way, or confirmed graft failure following a previous ACL reconstruction — including those with tunnel malposition, reinjury, or incomplete healing.
How the Procedure Works
Pre-operative Assessment
MRI and CT scans assess the failed graft, tunnel positions, bone stock, and any associated cartilage or meniscus damage; graft selection and surgical approach are planned accordingly.
Anaesthesia & Arthroscopic Access
Regional or general anaesthesia is administered; small keyhole incisions allow insertion of the arthroscope for a clear, magnified view of all joint structures.
Removal of Failed Graft
The damaged graft is identified and removed; previous tunnel placement and bone stock are carefully evaluated to determine whether tunnel correction or bone grafting is needed.
Tunnel Preparation
Malpositioned or widened tunnels are corrected or reconstructed to allow accurate anatomic placement of the new ligament graft.
New Graft Placement & Fixation
A new tendon graft — hamstring, patellar tendon, or donor source — is inserted through correctly positioned femoral and tibial tunnels and secured with surgical screws.
Inspection & Wound Closure
Stability and smooth joint motion are confirmed; instruments are removed, incisions are closed with sutures, and the knee is supported in a brace for early healing.
Outcomes
Who Needs This Treatment?
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Corrects failed graft, mispositioned tunnels, or re-torn ACL from previous surgery
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Restores knee stability and confidence during daily activity and sport
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Minimally invasive arthroscopic approach — smaller incisions, less tissue disruption
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Carefully planned graft selection tailored to individual anatomy and demands
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Prevents progressive cartilage and meniscus damage from ongoing instability
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Structured rehabilitation programme guides safe return to full activity
“Revision ACL surgery requires a thorough understanding of why the first procedure failed. Every case is unique — meticulous pre-operative planning, precise tunnel positioning, and structured rehabilitation are all essential to give the patient the best possible outcome.”
— Dr. Satish Reddy Gandavarapu, Senior Orthopaedic Consultant and Trauma Surgeon , Lux Hospitals, Hyderabad
Revision ACL Reconstruction Cost in Hyderabad
The cost of Revision ACL Reconstruction in Hyderabad generally ranges from ₹1,80,000 to ₹3,50,000, with an indicative average cost of around ₹2,65,000. Revision ACL reconstruction may be considered when a previous ACL reconstruction has failed or when persistent instability remains after the initial procedure. Revision surgery can be more complex than primary ACL reconstruction because of previous tunnels, graft condition, bone quality and associated meniscus or cartilage problems. The final cost depends on the cause of failure, graft selection, bone condition, implant requirements and whether staged treatment is required.
| Procedure | Approximate Cost Range |
|---|---|
| Revision ACL Reconstruction | ₹1,80,000 – ₹3,50,000 |
The above range is indicative; the final package and inclusions should be confirmed with the hospital before publication. Revision ACL reconstruction may require bone grafting, specialised fixation or staged reconstruction in selected patients. Associated meniscus, cartilage or ligament procedures can also affect the final cost.
Factors Affecting the Cost of Revision ACL Reconstruction
The overall cost of Revision ACL Reconstruction can vary depending on the reason for previous graft failure, condition of the existing bone tunnels, graft selection, knee stability, associated injuries and whether a single-stage or staged reconstruction is appropriate.
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Cause of previous ACL failure: Graft rupture, persistent instability, tunnel malposition, infection, trauma or other factors may require different revision strategies and levels of surgical complexity.
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Bone tunnel condition: Previous femoral and tibial tunnels may be enlarged, incorrectly positioned or otherwise unsuitable for immediate revision fixation. Bone grafting or staged reconstruction may be required in selected cases.
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Graft selection: The choice of autograft, allograft or another graft option depends on the patient's previous graft, anatomy, activity requirements and surgical plan and can influence the overall cost.
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Fixation implants: Revision surgery may require specialised screws, fixation devices or additional implants, and the number and type of implants can affect the final treatment cost.
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Meniscus and cartilage condition: Associated meniscus tears, cartilage damage or other intra-articular problems may require treatment during the same surgery and can increase the overall cost.
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Other ligament injuries: Additional ligament instability involving structures such as the MCL, LCL or posterolateral corner may require separate treatment when clinically indicated.
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Preoperative investigations: X-rays, MRI, CT scans, blood tests and other investigations may be recommended to assess the previous reconstruction and plan revision surgery. These may be billed separately when not included in the package.
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Rehabilitation: Revision ACL reconstruction generally requires structured postoperative rehabilitation and a gradual return to activity. Physiotherapy and follow-up costs may be separate from the surgical package.
Insurance Coverage for Revision ACL Reconstruction
Revision ACL Reconstruction may be covered by health insurance when medically necessary, subject to the patient's policy terms, exclusions, waiting periods, insurer approval and hospital coverage arrangements. Patients should confirm pre-authorisation requirements, implant and graft coverage and applicable out-of-pocket expenses with their insurer before treatment.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Satish Reddy Gandavarapu
Orthopaedic & Joint Replacement Surgeon
Dr. Satish Reddy at Lux Hospitals, Hyderabad, can evaluate patients with recurrent knee instability or a failed previous ACL reconstruction and help determine the cause of failure and whether revision ACL reconstruction is appropriate based on clinical examination and imaging. During the consultation, the doctor may assess: Knee instability: The doctor may review episodes of giving way, recurrent instability, pain, swelling and difficulty with sports, running or other activities. Previous ACL surgery: Details of the original reconstruction, graft type, fixation method, surgical date, recovery and any subsequent injuries may be reviewed. Ligament examination: Knee stability and the function of the ACL and other supporting ligaments may be assessed through physical examination. Previous tunnels and bone condition: X-rays and CT scans, when indicated, may be reviewed to assess tunnel position, tunnel widening, bone loss and other factors that can influence revision planning. Graft and joint condition: MRI findings may be evaluated to assess the previous graft, menisci, cartilage and other structures within the knee. Associated injuries: Meniscus tears, cartilage defects or additional ligament injuries may be assessed because they can influence the surgical plan and rehabilitation. Revision strategy: Based on the overall findings, the doctor may discuss single-stage or staged revision reconstruction and other appropriate treatment options depending on the condition of the knee.
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