Two-stage revision anterior cruciate ligament reconstruction: indications, review, and technique demonstration.

Revision anterior cruciate ligament reconstruction has inherent technical challenges not encountered during primary reconstruction. Prior tunnel placement and tunnel lysis can significantly alter graft fixation, compromising patient outcome. Preoperative recognition of patients with existing tunnel overlap and severe tunnel lysis will allow appropriate surgical planning and patient counseling, optimizing patient outcome. When single-stage revision is not possible in the presence of significant tunnel overlap and lysis, performing a 2-stage revision is recommended.