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revision ACL cases in consideration of when to do extra-articular procedures I will present one of my own failures which I thought the graft was in the right place we have to think about why an ACL reconstruction repair failed reconstruction failed was it surgeon error patient going back to quickly graft choice higher risk factors in the individuals such as recur bottom bony and others so when you do a revision now we have to decide whether to do an extra particular procedure and what procedure to do so weamp;#39;ll review those procedures and you must look in the literature from 30 years ago a generation ago we did a lot of extra articular reconstructions prior to our ability to do arthroscopically at ACL reconstructions and put it back in an anatomic spot Iamp;#39;m Meryl AirLand a 17 year old University of Kentucky freshman he was playing pick-up basketball landed awkwardly three months prior to my seeing him and he underwent a bone patellar tendon bone autographed and medial meni