[Anterior cruciate ligament reconstruction: indications and techniques]

The anterior cruciate ligament (ACL) is a key structure for the knee joint stability and is frequently injured. Patients can be classified as "low-risk" or "high-risk" to have subsequent knee instability or meniscal injuries. This risk is based on the pre-injury level of sports participation and on the initial knee stability. For low-risk patients (mostly sedentary, senior), conservative treatment with physiotherapy leads to a satisfactory outcome. For high-risk patients (the young, competitive athlete), early ligament reconstruction is mandatory. Numerous ACL reconstruction techniques exist with auto- or allografts. However these guidelines must be adapted to the patient characteristics, motivations and expectations, in order to offer a treatment "a la carte".