[Considerations in differential therapy of insufficiency of the anterior cruciate ligament. Principles and clinical consequences].

Ruptures of the anterior cruciate ligament are among the most frequent injuries of the joints. There is no longer any doubt regarding the necessity for surgical intervention. Several clinical and experimental studies suggest that the instability of the knee joint results in an accelerated degeneration of the menisci and cartilage. There are differences of opinion regarding the type of surgical procedures to stabilize the knee-joint. Although there are many different surgical procedures described in various publications, only one technique emerges as the preferred one. This paper will demonstrate different therapeutic concepts, based on the biomechanical background for the treatment of the anterior knee instability. It will consider the morphology of injuries, the demands of the patient and the full range of rehabilitative possibilities. Described herein are the indications and techniques of augmentation, protection and prosthetic replacement.