Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 11 3 2025 09 03 116 23 Pouya Tabatabaei Irani Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran Mohammad Ayati Firoozabadi https://orcid.org/0000-0002-2158-0484 Mehdi Bayati https://orcid.org/0009-0006-4099-6633 Seyed Hossein Jahanbakhsh https://orcid.org/0009-0005-7957-2849 Abdolsalam Razzaghi https://orcid.org/0009-0009-4484-8349 Hesam Toofan https://orcid.org/0000-0003-4889-2805 Seyed Mohammad Javad Mortazavi Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran 2025 04 21 2025 09 03 In anterior cruciate ligament reconstruction (ACLR) revision, orthopedic surgeons are faced with many obstacles in decision- making and finding the best approach. Here we discuss these challenges and review a staged approach for better understanding and practical implications in ACL revision. https://jost.tums.ac.ir/index.php/jost/article/view/675 https://jost.tums.ac.ir/index.php/jost/article/download/675/428