Biomechanics of the ACL and ACL Reconstruction: New Concepts and Applications

The anterior cruciate ligament (ACL) possesses a complex geometry that encompasses portions of differing lengths which display differing functions depending on knee orientation and external loading. It is well documented as a major stabilizer of knee motion, and is, not surprisingly, also the most commonly injured knee ligament. Due to the inability of the ACL to heal spontaneously when torn at its mid-substance, it has been extensively studied during the last few decades. In this chapter, important biomechanical concepts and studies relating to the ACL will be reviewed and the clinical application of this knowledge will also be discussed. Particular attention will be placed on the measurement of structural properties of the femur-anterior cruciate ligamenttibia complex (FATC) as well as on the evaluation of the role of the ACL in overall knee kinematics. Assessment of ACL contribution through measurements of length, strain, and force changes in the ACL will be discussed, as well as the application of recently introduced robotic technology. Through review of these areas, a more detailed picture of the complete contribution of the ACL to total knee function will be provided.

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