Current trends in anterior cruciate ligament reconstruction part 1: Biology and biomechanics of reconstruction

With today's increasing emphasis on sporting activities, the incidence of anterior cruciate ligament injuries has also increased. Epidemiologic studies estimate that the prevalence of anterior cruciate ligament injuries is about 1 per 3000 Americans. Management of these injuries has evolved from nonoperative treatment to extracapsular augmentation and primary ligament repair to anterior cruciate ligament reconstruction. Treatment of these injuries has significantly improved over the last few decades with the application of knowledge gained from both basic science and clinical research. This article is composed of two parts. The first part reviews the biology and biomechanics of the injured anterior cruciate ligament and the basic science of reconstruction. In the second part, to be published later, current operative concepts of reconstruction, as well-as clinical correlations, are reviewed. Summarizing the latest information on basic scientific as well as clinical studies regarding the anterior cruciate ligament, this article intends to demonstrate the correlation between the application of basic science knowledge and improvement of clinical outcomes.