[Indications for anterior cruciate ligament reconstruction--current surgical techniques, choice of transplant]

At present there is still a great deal of uncertainty about the natural history of ruptures of the ACL. The literature reveals that a significant number of secondary meniscus lesions and chondral damage results, when a high activity level is maintained. Reconstruction of the ACL now improves objective stability and decreases the meniscectomy rate in a large number of cases. Replacement with a patellar tendon or semitendinosus graft and augmented repair give better results than primary suture of the ligament. A limited arthrotomy or an arthroscopic technique should be used for reconstruction of the ACL. Two tunnel techniques with a lateral incision and single incision techniques with a femoral half tunnel are used. There is no consensus at present on the optimal graft source and surgical technique for ACL reconstruction.