Orthopedic Sports Medicine

pp 341-357

Anterior Cruciate Ligament Injuries

  • S. Zaffagnini
  • , F. Giron
  • , G. Giordano
  • , H. Ozben

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Rupture of the anterior cruciate ligament (ACL) is a common athletic injury and the most common cause of acute knee hemarthrosis. It usually occurs during a non-contact episode of rapid deceleration, lateral pivoting, or landing. Meniscal and chondral lesions may accompany the initial trauma or they may develop as secondary lesions. The risk of osteoarthritis is high after ACL rupture, regardless of the treatment. While the treatment of choice is surgical reconstruction, some patients may benefit from conservative treatment, which consists of specialized training programs. Nevertheless, most patients require surgery. Single-bundle reconstruction can prevent anterior translation but the double-bundle technique has better results in achieving rotational stability. Favorable outcomes have also been reported with the non-anatomic double-stranded hamstring technique. Postoperative rehabilitation is an important part of treatment. However, only prevention can eliminate the poor consequences typically associated with ACL rupture.