Individualized Anatomical Anterior Cruciate Ligament Reconstruction

The anterior cruciate ligament (ACL) is a dynamic structure, rich in neurovascular supply and comprised of two distinct bundles, which function synergistically to facilitate normal knee kinematics in concert with bony morphology. As there in considerable variation across individuals regarding ACL width and orientation, footprint size, and notch morphology, individualized, anatomic ACL reconstruction is the functional restoration of the ACL to its native dimensions, collagen orientation, and insertion sites according to the unique, individual anatomy. By adapting the surgery to the anatomy of each individual patient, the surgeon creates an appropriately sized and positioned graft for superior restoration of knee kinematics, in turn improving clinical outcomes. This chapter reviews individualized anatomical ACL reconstruction, including preoperative planning, surgical technique, and postoperative rehabilitation.