Matching the Anterior Cruciate Ligament Graft to the Patient

The aim of anterior cruciate ligament (ACL) reconstruction is to restore normal knee functioning. Key to successful ACL reconstruction understands how to match the ACL graft to the bone tunnel while taking into account interpatient variances. Bone tunnel location and size should be determined according to the original ACL footprint anatomy of each patient. Therefore, appropriate assessments of individual anatomy should be obtained before surgery using imaging techniques. Additionally, graft type should be carefully selected after fully considering biomechanical properties, donor site morbidities, patient activities and lifestyle, and patient preference. This report describes technical issues associated with imaging assessments of ACL anatomy and summarizes the features of currently available graft materials. Despite advancements in ACL reconstruction, certain points remain unclear, such as how much of the native ACL footprint should be covered by the reconstruction graft during surgery. Therefore, further studies are needed to improve the optimum matching of grafts to the requirements of each individual patient.