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Second ACL surgery can be more difficult

Terrell Thomas of the New York Giants is

Terrell Thomas of the New York Giants is introduced against the Washington Redskins. (Dec. 5, 2010) Photo Credit: Getty Images

For players who tear an ACL in a knee that has already had that injury like Terrell Thomas did, the second time is not a charm.

“While technical advancements have led to 95 percent of athletes getting back to their previous level after ACL reconstruction, the results of what we call revision ACL surgery are significantly worse,” said Dr. Craig Levitz, Chief of Orthopaedic Surgery at South Nassau Community Hospital.

Thomas tore his right ACL in 2005 when he was playing for USC. Last night he tore it again, this time after having the leg buckle under a collision with teammate Jason Pierre-Paul while the two were chasing after Bears quarterback Jay Cutler.

Levitz said that the doctor who performs Thomas’ upcoming surgery, likely team physician Russ Warren, will have to deal with removing or avoiding any screws that were placed during the original surgery if there were any. He said there are often cysts and other problems that “make it more difficult to duplicate a normal ACL.”

Levitz has not examined Thomas’ knee nor is he aware of details pertaining to his current or previous injuries.

Levitz did say that ACLs are usually reconstructed by harvesting the middle third of the patella tendon. “If that was done on 2005, he’ll have to chose a different graft,” he said. Cadaver grafts are not as good as the body’s own tissue, Levitz said, and hamstring tendons are not ideal in revision surgery. Scar tissue makes it difficult to re-harvest from the same knee. Often the best situation is to take the tissue from the good knee and put it in the injured one. “It sounds crazy, but it works,” Levitz said. “In essence, there is no ideal choice.”

Once the surgery is completed, though, Thomas will have to rehabilitate the knee just as he did in 2005 and just as every other football player does when suffering the injury. It’s complicated, but Levitz said that the chances of him continuing his career are very good.

“Even with all that to deal with, the chances of him making it back and making a 100 percent recovery are very high and I fully expect to see him on the field next year,” he said.

Those without medical degrees agree.

“He’s a tough guy," safety Antrel Rolle said. "It’s nothing he hasn’t been through before. He’s torn it before and he’s worked extremely hard to get to where he was. There’s nothing saying he’s not going to do the same now.”

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