Anterior cruciate ligament reconstruction is a commonly performed orthopedic procedure with more than 100,000 reconstructions performed annually in the United States. Despite improved surgical techniques and rehabilitation protocols, anterior cruciate ligament reconstruction failure rates range from 5% to 25%.
There are numerous reasons why anterior cruciate ligament reconstructions (ACLRs) fail; however, when they do, patients complain of continued knee instability. At the time of revision surgery, a surgeon must be cognizant of a variety of factors, such as the prior surgical technique performed, prior graft(s) utilized, previous tunnel placement, limb alignment, tunnel osteolysis and any fixation devices that may be implanted. Any of these factors can make revision ACL reconstruction more technically demanding than the index surgery. Surgical planning for revision ACLR is often guided by these factors.