Secondary Stabilizers of the Anterior Cruciate Ligament-Deficient Knee

Eliminating rotatory knee instability during anterior cruciate ligament (ACL) reconstruction surgery is crucial to ensure patients return to normal function after ACL injury. Although the ACL is generally considered the primary soft tissue restraint to anteroposterior laxity of the knee, several additional structures, such as the anterolateral complex of the knee, lateral and medial menisci and their capsular attachments, posterolateral corner structures, and collateral ligaments, also play important roles in knee stability. The primary goal of ACL reconstruction surgery should be to recreate the anatomical location and function of the native ACL, and injuries to these other secondary restraints should also be evaluated and addressed surgically if necessary.