ACL ligament tear is one of the most common injury to the knee. It results from twisting injury to the knee playing sports, accident or trauma. The ACL ligament is normally attached to the thigh bone (femur) & shin bone (tibia) & provides stability to the knee. Once completely torn, the knee becomes unstable (instability). In young active patients, ACL reconstruction is an established technique to allow return to function. However, when there is a subsequent ACL graft tear due to re-injury, Revision ACL reconstruction is indicated. The Quadriceps autograft is an available option in revision cases to reconstruct the new ACL. This graft requires fixation to the femur & the tibia  which can be done with conventional fixation devices i.e. screw or by performing the advance All Inside ACL Reconstruction technique which offers several advantages i.e. reduced post-op pain, bone preservation in presence of previous surgery & stronger fixation strength.