Who Needs ACL Surgery

Anterior cruciate ligament (ACL) rupture is common in the general population, with an incidence of up to 75 per 100,000 person-years (Herzog et al., Sports Health 10(6):523–531, 2018), and is occurring more frequently in the young, active population with early sports participation (Beck et al., Pediatrics 139(3):e20161877, 2017). Following careful evaluation and accurate diagnosis with history, physical examination, and relevant imaging, surgical reconstruction of the ruptured ACL may be performed using various graft types and fixation techniques, with the goal of return to sport restoration of knee stability and prevention of degenerative changes (Sanders et al., Am J Sports Med 44(7):1699–1707, 2016; Sanders et al., Knee Surg Sports Traumatol Arthrosc 25(2):493–500, 2017). As incidence of ACL injury and ACL reconstruction continue to increase, it is imperative to define clear indications for who needs ACL surgery.