Beynnon et al. reviewed 3810 ACL citations (1994–2005) to synthesize the highest-level evidence on ACL biomechanics, epidemiology, natural history, associated injuries, risk factors, and treatment indications — including nonoperative management and graft selection for reconstruction. Part I of a two-part series.
When counseling an active patient with a complete ACL tear, use this review to frame the conversation: untreated ACL deficiency leads to progressive meniscal damage and eventual OA in the majority — but reconstruction eliminates instability without guaranteeing OA prevention, and graft choice (PT vs 4-strand hamstrings) should factor in the patient's kneeling demands and extension requirements rather than expected laxity outcomes alone.
Beynnon et al. reviewed 3810 ACL citations (1994–2005) to synthesize the highest-level evidence on ACL biomechanics, epidemiology, natural history, associated injuries, risk factors, and treatment indications — including nonoperative management and graft selection for reconstruction. Part I of a two-part series.
When counseling an active patient with a complete ACL tear, use this review to frame the conversation: untreated ACL deficiency leads to progressive meniscal damage and eventual OA in the majority — but reconstruction eliminates instability without guaranteeing OA prevention, and graft choice (PT vs 4-strand hamstrings) should factor in the patient's kneeling demands and extension requirements rather than expected laxity outcomes alone.