Revision Anterior Cruciate Ligament Reconstruction (ACLR): Causes and How to Minimize Primary ACLR Failure



1 1. Twin Cities Orthopedics, Edina, MN, USA 2. University of Minnesota Medical School, Minneapolis, MN, USA

2 1. Twin Cities Orthopedics, Edina, MN, USA 2. Georgetown University School of Medicine, Washington, DC, USA

3 1. Twin Cities Orthopedics, Edina, MN, USA


Anterior cruciate ligament (ACL) tears are a common orthopaedic injury, particularly in athletic populations. Primary ACL reconstructions (ACLR) have fairly successful outcomes; however, there is a subset of patients who experience failure or re-injury and require a technically challenging revision ACLR procedure. Knowledge of the clinically relevant ACL anatomy and biomechanics, including closely associated meniscal, ligament, and osseous structures, is fundamental for an anatomic revision ACLR. Comprehensive evaluation and diagnosis are also critical to identify the causes of primary ACLR failure and determine appropriate treatment(s). Although outcomes have improved over time, revision ACLR patients still experience sub-optimal outcomes compared to primary ACLR patients. This review will highlight the current concepts of anatomy, biomechanics, clinical evaluation, treatment, outcomes, and post-operative rehabilitation to optimize outcomes for revision ACLR procedures.


Articles in Press, Accepted Manuscript
Available Online from 15 February 2022
  • Receive Date: 06 September 2021
  • Revise Date: 24 December 2021
  • Accept Date: 09 January 2022
  • First Publish Date: 15 February 2022