[Rupture of the anterior cruciate ligament]

Despite the frequency of injuries to the anterior cruciate ligament (ACL) among athletes exercising pivoting and contact sports, there is a lack of unanimity on its natural history, the role of surgery, and the most effective surgical treatment. Although in some patients the ACL-deficient knee remains relatively asymptomatic and the patients are able to return to strenuous athletic activities, at least over a short-term period, in others the knee becomes severely disabled and dysfunctional following ACL tear. Level of activity, age and sports career ambitions are the most important determining factors in choosing the right treatment. Clinical outcome also depends on concomitant intra-articular pathology, specially on cartilage damage. Delaying surgery has been recognized as a major factor in preventing the development of joint stiffness. The arthroscopically assisted ACL reconstruction has become an accurate and reproducible procedure providing excellent and predictable results. Complications and pitfalls can be avoided, if the surgeon critically assesses his technical ability to perform this advanced procedure. To consider a reconstructed knee as a success, the athlete must be able to return to his preinjury sports level without any restrictions.