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



1 1 Twin Cities Orthopedics, Edina-Crosstown, 4010 W 65th St, Edina, MN, 55435 USA 2 University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455 U.S.A

2 1 Twin Cities Orthopedics, Edina-Crosstown, 4010 W 65th St, Edina, MN, 55435 USA 2 University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455 U.S.A 3 Georgetown University School of Medicine, 3900 Reservoir Rd NW, Washington, DC 20007

3 Twin Cities Orthopedics, Edina-Crosstown, 4010 W 65th St, Edina, MN, 55435 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. 
Level of evidence: V


Main Subjects

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