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there has been evidence recently that the the slope of the bone basically your tibia might have an abnormal shape to it that might require bony procedures to actually fix the slope of the itamp;#39;s called the slope of the tibia so the slope of the tibia might be abnormal and that might be causing more stress on the ACL to make it more susceptible to tearing so if someone that I see has multiple ACL surgeries that have been failing you have to take a step back and figure out what else could be the problem besides the ACL and many times it can be the anatomy of the knee or other structures within the knee that are not addressed like the meniscus or the MCL or LCL or something else happening because the ACL is seeing more stress than it should be