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this is dr andrew young at st johns in santa monica and were 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 theres often ligamentous sometimes multi-ligamentous injury theres post-traumatic scarring theres deformity and theres also the problem of hardware used to fix the acl graft so of all those topics were just going to take a deep dive in how we manage hardware removal using the robotic system okay so well 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 theres loss of joint space theres irregularity in the medial femoral condyle theres subluxation or shifting of the tibia but very importantly this patient with a prior acl has an interference screw in the femur and in the tibia and this is the position when w
