A proposed natural history of symptomatic anterior cruciate ligament injuries of the knee.

This article highlights the symptoms and clinical findings associated with anterior cruciate ligament instability. The symptomatic anterior cruciate ligament-deficient knee presents as an acute isolated incident or as a chronic progression of recurrent episodes of instability. The results of 71 patients diagnosed with an anterior cruciate ligament instability to the knee are reported. No distinction was made between the acute and chronic injuries as both patient populations received the same surgical procedure. The Lachman's test and the pivot shift test are the clinical examinations used to document cruciate ligament instability. The recommended procedure of choice for the symptomatic anterior cruciate-deficient knee is an autogenous patella tendon graft, bone-tendon-bone preparation, arthroscopically placed in an isometric position within the knee joint. A rehabilitation program for the reconstructed knee is outlined.