The Anatomy of ACL Revisited

Focuses on hip, knee and lower extremity and sports medicine. This title details the ACL anatomy, with special focus on the functional anatomy of ACL, the rupture pattern of ACL bundles, the insertion site anatomy of each bundle of ACL, and the clinical application of the anatomical landmarks.

This title focuses on hip, knee and lower extremity and sports medicine. ACL reconstruction is the sixth most frequently performed orthopaedic procedure in the United States. However, as the technique of ACL reconstruction evolves, we have drifted away from the main orthopaedic principle of restoring anatomy. True, the outcome of ACL reconstruction tends to be good, but there is ample room for improvement. Currently, only 65-70 per cent of patients return to their pre-injury level of sports activity, and 90 per cent have radiographic evidence of arthritic changes at an average follow-up of 6.6 years. To restore ACL anatomy, we must restore the two-bundle anatomy and reproduce the insertion site and tension pattern of each bundle. Finally, the surgery should be tailored to fit for each patients unique anatomy. In this presentation, the authors detail the ACL anatomy, with special focus on the functional anatomy of ACL, the rupture pattern of ACL bundles, the insertion site anatomy of each bundle of ACL, and the clinical application of the anatomical landmarks. Additionally, several pitfalls of performing anatomic ACL reconstructions are discussed.