Many surgeons intend to replicate the native anterior cruciate ligament (ACL) as much as possible, aiming at anatomic ACL reconstruction. An outline of new surgical preferences is starting to form; orthopedic surgeons have shifted their preferences in arthroscopic technique, graft type, and fixation during the past decade. The days of simple silk suturing of the native ACL stump to the femoral periosteum are over. Today, knee surgeons performing ACL reconstruction have a wide array of technical considerations, graft choices, and fixation techniques at hand that enable them to specifically tailor each reconstruction to each patient's anatomy and specific needs.
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