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this is dr andrew young at st johnamp;#39;s in santa monica and weamp;#39;re going to take a few moments and talk about one of the difficult challenges in knee replacement specifically replacing a post-traumatic knee after a prior acl repair now this turns out to be one of the most difficult operations because thereamp;#39;s often ligamentous sometimes multi-ligamentous injury thereamp;#39;s post-traumatic scarring thereamp;#39;s deformity and thereamp;#39;s also the problem of hardware used to fix the acl graft so of all those topics weamp;#39;re just going to take a deep dive in how we manage hardware removal using the robotic system okay so weamp;#39;ll start with the most common type of post-traumatic arthritis that we see after an acl repair so we see a lot of arthritic change thereamp;#39;s loss of joint space thereamp;#39;s irregularity in the medial femoral condyle thereamp;#39;s subluxation or shifting of the tibia but very importantly this patient with a prior acl