Editorial Commentary: Bony Morphology Determines the Extent of Concomitant Injuries in Anterior Cruciate Ligament Injured Knees.

The bony morphology of both tibia and femur has been found to influence the risk of anterior cruciate ligament (ACL) injuries. Quantifying the femoral condylar's sagittal morphology, the lateral femoral condyle ratio (LFCR) has been associated with injuries to the anterolateral knee joint capsule, including the anterolateral ligament in ACL-injured knees. Rotational instability may be in part attributable to femoral anisometry with an increase of the LFCR contributing to increased laxity and risk for ACL ruptures as well as concomitant injuries. While there is currently no surgical treatment available to change the bony morphology of the femur, possibilities such as the addition of a lateral extra-articular tenodesis, adjustment of graft selection, or modification of surgical techniques may mitigate the risk of ACL rerupture in patients with a high LFCR.