Variations in Anterior Cruciate Ligament Anatomy

The aim of anterior cruciate ligament (ACL) reconstruction is to restore native ligament anatomy to potentially restore function. Morphologic measurements of the native ACL are a valuable asset to effective surgical planning, influencing decisions such as graft choice and single- vs double-bundle reconstruction. Several studies support the existence of high interindividual morphologic variabilities, an important factor that should be taken into account for each patient to ensure native ligament anatomy restoration and function. Anatomical features that can be objectively evaluated before and during ACL reconstruction surgery include the ACL length, tibial and femoral insertion site sizes, inclination angle, and intercondylar notch size.