Management of Bone Loss and Tunnel Widening in Revision ACL Reconstruction

(sic) Both mechanical and biological factors can contribute to bone loss and tunnel widening following primary anterior cruciate ligament (ACL) reconstruction. (sic) Revision ACL surgery success is dependent on graft position, fixation, and biological incorporation. (sic) Both 1-stage and 2-stage revision ACL reconstructions can be successful in correctly indicated patients. (sic) Potential future solutions may involve the incorporation of biological agents to enhance revision ACL surgery, including the use of bone marrow aspirate concentrate, platelet-rich plasma, and bone morphogenetic protein-2.