A failed ACL reconstruction is a different problem from a first-time tear — and it needs a different surgeon. Mr Osman Riaz, consultant orthopaedic knee surgeon, runs one of the largest revision ACL practices in the north of England. Patients are referred and self-refer from across the UK, particularly when a graft has re-ruptured, the knee remains unstable after surgery, or they have been told that nothing more can be done.
30
Revision ACL reconstructions each year
120
Primary ACL reconstructions each year — the highest volume in Yorkshire
60
LET procedures each year to protect the new graft
Why ACL grafts fail — and why finding the cause matters
Repeating the same operation that failed the first time rarely works. Grafts fail for identifiable reasons: tunnel malposition, an excessive posterior tibial slope, unaddressed rotational instability, missed meniscal or ligament injuries, or a new sporting injury. A successful revision starts with finding your reason — which is why every revision assessment includes long-leg alignment X-rays, slope measurement, MRI, and where needed CT of the bone tunnels. Mr Riaz has written in detail about why ACL grafts fail and when the tibial slope needs correcting in revision ACL surgery.
A revision practice with the full toolkit
- Revision ACL reconstruction with graft choice tailored to what was used before — including quadriceps tendon grafts
- Lateral extra-articular tenodesis (LET) to protect the new graft against rotational re-rupture
- Tibial slope-correcting osteotomy where an excessive slope would doom a standard re-do
- Staged bone grafting when previous tunnels are widened or malpositioned
- Meniscal repair and meniscal transplant where meniscal loss is driving instability
- Multi-ligament reconstruction for combined injuries — around 20 complex cases a year
Second opinions welcome
Many revision patients arrive having lost confidence — in the knee, and sometimes in the process. A second opinion consultation reviews your previous operation notes, imaging and rehabilitation honestly. Sometimes the answer is revision surgery; sometimes it is targeted rehabilitation, an osteotomy, or realistic advice about returning to sport. Mr Riaz holds a FIFA Diploma in Football Medicine and publishes and teaches on revision ACL surgery, so the advice you receive reflects current evidence rather than a single preferred operation.
Practical information for patients travelling to us
Clinics are held at Spire Elland Hospital (just off the M62, around 30 minutes from Leeds and Manchester) and The Huddersfield Hospital. Imaging can usually be arranged around your consultation to minimise repeat visits, and rehabilitation is coordinated with a physiotherapist near your home. Most major private medical insurers are accepted and self-pay options are available — see the ACL surgery cost guide for typical fees. Call 01422 702951 (Spire Elland) or 01484 533131 (Huddersfield).
Related: lateral extra-articular tenodesis (LET) • graft choice in revision surgery • costs.
