Technical pitfalls of anterior cruciate ligament surgery

Anterior cruciate ligament (ACL) reconstruction is extremely common. Although the number of primary reconstructions is increasing, failures and revision procedures continue to occur at approximately the same frequency. ACL reconstruction is a technically difficult procedure, and many failures can be attributed to surgical error. This article addresses the causes for failure of primary ACL reconstruction that lie within the surgeon's control. Preoperative assessment, surgical technique, and rehabilitation are addressed.