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Revision of anterior cruciate ligament reconstruction presents various challenges not encountered in the primary settings, including malpositioned tunnels, tunnel widening, and the lack of consensus on the ideal graft to be used. This Technical Note describes a one-stage anterior cruciate ligament reconstruction revision using a bone-patellar tendon-bone autograft combined with lateral extra-articular tenodesis. This technique represents the ideal approach to tackle complex revision cases primarily characterized by tibial and femoral tunnel osteolysis and rotational knee instability.

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