Purpose The purpose of this study was to identify risk factors for revision surgery following primary anterior cruciate ligament (ACL) reconstruction. Methods A retrospective analysis of 2,965 patients who underwent a primary ACL reconstruction were separated into two groups: those who returned to our center for revision of their reconstruction (n = 67) and those who did not return to our center for revision of their reconstruction (n = 2,898). Patient characteristics assessed at the time of primary reconstruction include age, gender, graft type, graft source, meniscal and/or chondral injury, sport, side of effected extremity, level of competition, and surgeon. Multivariable analyses were performed to identify significant, independent associations with the need for revision. Results The portion of patients who returned for revision reconstruction after primary ACL reconstruction was 2.3% (67/2,965). Age (p < 0.001), sport type (p = 0.007), and level of participation (p < 0.001) were significantly different between the nonrevision and revision patients. Graft type preferences varied among surgeons (p < 0.001). Accounting for sport type or level of competition, age (p = 0.014) and surgeon (p = 0.041) were independently associated with revision. Gender, extremity (R vs. L), meniscal or chondral injury, and graft characteristics were not associated with revision. Conclusion Revision of primary ACL reconstructions is independently associated with age and choice of surgeon at the time of primary reconstruction.
