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Risk factors Involved in Re-injuring a Reconstructed ACL or Having a Contralateral Injury

ACL injury and reconstructive surgery is a tough process for anyone.  And, no one wants to go through this challenging time twice.  So, what can put someone at a higher risk for re-injuring their reconstructed ACL or even tearing their ACL on the other leg?

There are many different factors that can lead to a reconstructed ACL graft re-rupture or an ACL injury on the other leg.  A few of these factors are not always under our control.  In a case control study published in 2014, researchers looked at different factors in the incidence of ACL graft re-injuries on the same leg or an ACL injury to the contralateral (opposite) knee upon return to activity.  When analyzing the data gathered from a large pool of patients that had undergone ACL injury with reconstructive surgery (3 year minimum follow up), it was found that the following factors seemed to be consistently found in those that experienced re-injury or injury to their other ACL:

  • 20 years of age or younger
  • Return to pivoting or cutting sports/activities
  • Family history of ACL injuries

During rehabilitation with a patient that has undergone ACL reconstruction surgery, the physical therapists at Omaha Physical Therapy Institute try to focus on the things we can control which, if limited or restricted upon returning to sports, can increase the risk of re-injury/injury.  This includes maximizing strength, neuromuscular control, mobility, and confidence with returning to function and sport specific skills and agility.  Time since surgery is also a factor in decreasing the risk of re-injury/injury.  Research shows that waiting at least 9 months to return to play can decrease the risk of re-tear significantly.

If you have any questions or have an ACL injury and need physical therapy, give Omaha Physical Therapy Institute a call today!


Webster KE, Feller JA, Leigh WB, Richmond AK. Younger patients are at increased risk for graft rupture and contralateral injury after anterior cruciate ligament reconstruction. Am J Sports Med. 2014 Mar;42(3):641-7. doi: 10.1177/0363546513517540. Epub 2014 Jan 22. PMID: 24451111


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