1. Examination: Before deciding on revision surgery, doctors will check how stable your knee is and how well your ACL is working. They will also look at old X-rays or scans to see how the previous surgery was done.
2. One or Two Stages:
   • One-Stage Procedure: If everything looks good, the revision surgery can be done in one surgery.
   • Two-Stage Procedure: If there are problems with the old surgery, like incorrectly placed tunnels or larger holes in your bone from your previous surgery, the surgery might be done in two steps. In the first step, doctors fill in the old holes with bone. In the second step, they perform the ACL repair.

• Knee Brace: You will need to wear a special knee brace that keeps your leg straight for about 4-6 weeks while walking.
• Recovery Time: It usually takes 9-12 months before you can go back to high-intensity activities to make sure your knee heals properly.

ALL Reconstruction and LET are special surgeries used to make the knee more stable, especially for people who have had ACL injuries. The anterolateral ligament (ALL) is a ligament that plays a vital role in your knee stability. Reconstructing or repairing the ALL with an ALL reconstruction or a LET when performing an ACL surgery has been shown to decrease rates of retear of the ACL.

When Might You Need These Surgeries?

1. Rotational Instability: If your knee has a high grade of rotational instability when twisting or cutting these surgeries might help.
2. Failed Previous Surgery: If your first ACL surgery didn’t work, these methods could be the next step to decrease the chance of your second ACL surgery failing again.
3. High Risk of Future Injuries: If you’re young, very active, have hyper mobility or risk factors that put you at greater risk for ACL surgery failure, you could be a great candidate for these surgeries.

• Improved Stability: Studies show that these surgeries have decrease the chance of an ACL surgery failing and increase rotational stability in the knee.
• Better Health for Other Knee Structures: They also help protect other parts of your knee, like the cartilage and meniscus (soft tissues) by decreasing excessive loads and torques on these structures.

• ALL Reconstruction: Doctors make small cuts around the knee and put in new tissue to replace the damaged ligament.
• LET Procedure: This involves tightening the iliotibial band on the lateral side (outer side) of the knee to decrease the amount of rotation on the knee when cutting and twisting.