The Functional and Surgical Anatomy of the Anterior Cruciate Ligament

Recent literature has improved our knowledge of the anatomy of the anterior cruciate ligament (ACL). In the setting of an ACL tear, the goal should be to reconstruct the function of the ACL to allow the athlete to return to full unrestricted activity. To accomplish this, anatomic reconstructions must be performed. Thus, the surgeon must be familiar with the arthroscopic anatomy of the ACL and the anatomy of the ACL footprint so that reconstructions can recreate the native ACL anatomy. Because ACL function is directly related to its anatomy, a better understanding of the anatomy of the ACL may help the surgeon to achieve an anatomic reconstruction and improve clinical outcomes. This manuscript will review the neurovascular and gross anatomy, the functional anatomy, the surgical landmarks, and footprint anatomy, as well as the radiographic anatomy of the ACL.