Anatomic revision ACL reconstruction

Anterior cruciate ligament (ACL) injuries are common in the athletic population. In fact, ACL reconstruction has become one of the most common orthopedic procedures with over 100,000 being performed annually. As the number of primary ACL reconstructions continues to increase, so will the need for revision surgery. The causes of failure are numerous and multifactorial. However, understanding the exact cause of failure before undertaking a revision ACL surgery is paramount in providing the patient with a successful outcome. It is our belief that anatomic restoration of ACL anatomy in the revision setting is best accomplished using the double-bundle technique in the majority of cases. This is a technically demanding procedure that requires proper preoperative preparation. This article outlines our approach to these challenging situations.