[Revision surgery after failed anterior cruciate ligament repair]

Not every reconstruction of the anterior cruciate ligament is successful. Possible reasons for failure are renewed severe trauma, inadequate fixation of the transplant, an isometric mistake, weak transplant material, an anterior cruciate ligament reconstruction performed in isolation in a complex unstable knee, or prosthetic ligaments. Revision surgery is indicated when patients complain about the recurrence of knee instability. Preoperative diagnostic procedures must include X-rays with the knee in defined positions in order to determine drill hole courses and visualize any signs of arthrosis and the patellar position. Revision surgery is hampered by disadvantageously placed drill holes, exhaustion of the supply of transplant material, secondary instabilities, gonarthrosis or a possible arthrofibrosis. During rehabilitation a variable knee position is imperative, because of the different procedures that might need to be implemented.