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Revision ACL surgery is sure to become more common as the numbers of primary ACL reconstruction increase, due to recurring trauma or failures from technical problems. Special attention to the causes of graft failure is important, because technical errors in tunnel placement, graft fixation, progressive loss of bone and other areas can be corrected. Repetitions of treatment errors must be avoided. The choice of tissues (allografts, ligament protheses, etc.) is also a major point for the long-term outcome after revision ACL surgery. The ability to resume a top level sporting activity must be considered realistically by both surgeon and patient.