ACL revision surgery is a procedure performed when a patient's anterior cruciate ligament (ACL) reconstruction has failed. This transcript delves into the reasons for ACL revision and the considerations to be taken prior to the surgery. The episode discusses various factors that can contribute to the failure of an ACL graft, such as improper tunnel positioning and size, alignment issues, meniscus tears, and ligament instability. It highlights the importance of preoperative planning and the need to assess the patient's unique situation before proceeding with a revision. The episode also explores different graft options, mentioning autografts and allografts, and emphasizes the significance of choosing the most suitable graft for each individual. Additionally, it touches upon the possibility of staging the procedure if bone grafting, osteotomy, or additional ligament reconstruction is necessary. Overall, this transcript provides valuable insights into ACL revision surgery and the importance of tailoring the approach to each patient's specific needs.