Advances in anterior cruciate ligament surgery.

The anterior cruciate ligament is the most frequently torn ligament in the knee. Diagnosis of cruciate ligament tears is often a difficult task. Tests typically used in diagnosis are the anterior drawer test, Lachman's test, pivot shift test, and the flexion rotation drawer. Arthroscopy has increasingly become the standard for the diagnosis of anterior cruciate ligament tears. Management of these tears has been controversial. The diagnostic techniques are discussed and a surgical technique is described for anterior cruciate ligament reconstruction as an outpatient procedure. The middle one-third of the patellar tendon is used as a graft, harvested subcutaneously, and fixed with interference fit screws. The postoperative function of anterior cruciate ligament deficient knees has been quite satisfactory. Morbidity is decreased relative to open surgical inpatient procedures. Finally, overall cost to the patient has been significantly reduced.