Anterior cruciate ligament reconstruction: current concepts and latest thinking

Never has there been such focus on just one small ribbon-like ligament in the human body: the anterior cruciate ligament (ACL) is the most highly studied and highly written about ligament in the knee, and yet still, there seem to be many ongoing unknowns. Despite this, there seem to be even more so-called experts than papers, all with their own firm and didactic opinions. This review article provides a contemporary opinion on the subject of ACL tears and ACL reconstruction, with a focus on the diagnosis of ACL tears and the decision-making process, with respect to conservative versus surgical management. The review also discusses the topics of tunnel placement, graft options, internal bracing, the anterolateral ligament and, importantly, outcomes. This paper highlights that there are a number of different approaches and options, and emphasizes the importance of discussing the pros and cons of these options with your patients, thoroughly, with shared decision-making leading to fully informed consent.