Abstract
The evolution of anterior cruciate ligament (ACL) surgery, seemingly circular at times,
informs and provides context for past and current controversies in ACL management.
The purpose of this systematic review is to objectively summarize the historical course
of ACL reconstruction and repair in the United States over the last 40 years. Femoral
tunnel drilling and graft selection have evolved dramatically over the last few decades.
An initial focus on restoring ACL anatomy was for a period sacrificed for decreased
operative morbidity. However, recent developments in operative techniques aim to restore
ACL anatomy while also achieving minimal operative morbidity. Despite this historically
iterative process, there remains no perfect choice for the treatment of ACL tears.
Continued research on ACL repair, anatomic graft placement, graft choice, and augmentation
will help our patients over the next generation.
Keywords
anterior cruciate ligament - ACL surgery - sports medicine - systematic review