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ACL tears and ACL surgery fortunately most of the time works out quite well however in a number of cases the ACL reconstruction or repair fails and in that setting we can rebuild the ACL using stronger donor tissue now from the quadriceps tendon and we can understand their reasons for the failure which most commonly are either a misplacement of the first ligament or failure to understand the other ligaments and other tissues around the knee that are also damaged and so today whenever we do a revision reconstruction or rebuild a knee that has had a previous failed surgery were almost always combining it with a whats called a lateral extraarticular reconstruction where we add tissue on the side of the knee to diminish the excess rotation and stabilize the joint to help that new ACL have a more successful outcome so to summarize theres basically two major reasons that we see for ACLS to fail one is misplacement of the first graft two is a misunderstanding of all the injuries that occur
