Abstract
Despite improvement of the reconstruction techniques of the anterior cruciate ligament (ACL), a number of patients continue to present residual rotational instability and pivot shift following surgery. This has led to a search for the causes of such instability in other structures of the knee and in the bone morphology itself.
The reconstruction surgery of the ACL is not the only consideration; the rest of the structures that may be affected and which will need correct treatment. Diagnosing and adequately treating the ligamentous, meniscal and bony lesions associated to ACL rupture is mandatory.