title: Strategies for revision surgery after primary double-bundle anterior cruciate ligament (ACL) reconstruction.
abstract: OBJECTIVE
  The purpose of this article was to discuss pre- and intra-operative considerations as well as surgical strategies for different femoral and tibial tunnel scenarios in revision surgery following primary double-bundle anterior cruciate ligament (ACL) reconstruction.
  
  
  METHODS
  Based on the current literature of ACL revision surgery and surgical experience, an algorithm for revision surgery after primary double-bundle ACL reconstruction was created.
  
  
  RESULTS
  A guideline and flowchart were created using a case-based approached for revision surgery after primary double-bundle ACL reconstruction.
  
  
  CONCLUSIONS
  Revision surgery after primary double-bundle ACL reconstruction can be a challenging procedure that requires flexibility and a repertoire of surgical techniques. The combination of pre-operative planning with 3D-CT reconstruction, in addition to careful intra-operative assessment, and the use of this flowchart can simplify the ACL revision procedure.
  
  
  METHODS
  V.
authors.affiliation: Department of Orthopedic Surgery, University of Pittsburgh Medical Center, University of Pittsburgh, Kaufman Building Suite 1011, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA.
authors.forename: Marcus
authors.initials: M
authors.lastname: Hofbauer
authors.forename: Bart
authors.initials: B
authors.lastname: Muller
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Murawski
authors.forename: Michael
authors.initials: M
authors.lastname: Baraga
authors.forename: Carola Franziska
authors.initials: CF
authors.lastname: van Eck
authors.forename: Freddie H
authors.initials: FH
authors.lastname: Fu
mesh_terms: D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D012086:Reoperation / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods