[Knee joint function and the cruciate ligaments. Biomechanical principles for reconstruction and rehabilitation]

Trauma to the knee joint with disruption of one or both cruciate ligaments will start a biological response: inflammatory reactions, neurophysiological changes due to disruption of afferent nerve endings, and biomechanical changes which will ultimately lead to instability (functional and mechanical) as well as to early degenerative changes. Treatment, whether operative or non-operative, has to be based on a sound knowledge of biological and biomechanical principles. Cruciate ligament graft positioning, fixation, pre-tensioning, operative technique for reconstruction, and rehabilitation will all have influence on each other. All these factors therefore have to be balanced to achieve good mid- to long-term results.