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What could be the cause of pain at the bottom of my knee directly on top of my ACL surgery scar?

Question: What could be the cause of pain at the bottom of my knee directly on top of my ACL surgery scar?

I had an ACL surgery on my left knee almost ten years ago. The surgeon took my a piece of my patella from my right knee to use in my left ACL. I had amazing results and no real problems finishing out my collegiate career playing soccer. However, now when I walk I am having quite a bit of pain in my left knee. It is concentrated over the front ACL surgery scar and the most intense pain is at the very bottom of the scar where it feels like I am actually hitting my tibia. Squats definitely make it worse, but I can still run and play basketball and soccer in my leagues. I don't notice it too badly until afterward and I try to walk again. But then I am in so much pain that I hardly put any pressure on my knee at all. I get the same type of pain from just walking about 5 minutes also. Any ideas or suggestions?