Cruciate reconstruction is an operation performed to restore stability of the knee.
The majority achieve this, return to sport is the norm especially where no other injury has occurred to the knee. A small number of cruciate reconstructions fail. They probably fall into three categories: reinjury, initial injury more severe than suspected, or graft not in the right spot.
In this case, a previous LARS reconstruction left large holes in the bones close to the location of the new graft. Some revisions require two operations: the first to bone graft the defects, the second to do the new reconstruction with hamstrings, quadriceps tendon, or patella tendon.
In some instances we might use an allograft transplant from a donor. A variety of ways to secure the graft to the femur and tibia are possible, in this instance “interference screws” get fixation as close to the joint as possible. These RCI screws are an Australian design that has been used for over a decade, and a reverse thread screw used in the femur for right knees subtly improves the alignment of the reconstructed ligaments fibres.