Mechanism of injury and pathology of anterior cruciate ligament injuries.

The strides made in the last decade, such as contributions of Noyes and colleagues (secondary restraints), and Cabaud and coworkers (augmentation), Arnoczky and associates (microvascularity), and Peterson (elimination of the cross-body block), are enormous. An appreciation of the mechanics and pathology of the acute ACL injury is essential in the management of the acute and/or chronic ACL-deficient knee. This knowledge is helpful, as it relates to the blood supply, the secondary restraints, the role of augmentation, and injury prevention. A broad spectrum of recent research has been productive and is clinically applicable to our practice of sports medicine.