Anticipating problems unique to revision ACL surgery

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 the increasing number of primary ACL reconstructions being performed combined with the continued expectations of high-level athletes, revision ACL reconstruction is likely to become more frequent. Revision ACL reconstruction poses several diagnostic and technical challenges compared to primary reconstructions. The purpose of this article is to highlight problems that are unique to revision ACL reconstruction such as tunnel malposition, tunnel widening, preexisting hardware, and injuries to concomitant structures in the knee. Recognizing and avoiding these pitfalls are crucial to obtaining a successful result after revision ACL reconstruction.