Surgical techniques for anterior cruciate ligament (ACL) reconstruction have progressed in the past 20 to 30 years. In the 1970s, ACL reconstructions were done through large arthrotomies, using non-anatomic, extra-articular reconstructions, with long postoperative periods of immobilization.  In the 1980s, large arthrotomies were replaced by arthroscopic, anatomic, intra-articular reconstructions.  Arthroscopy eliminated the need for prolonged postoperative immobilization, and accelerated rehabilitation protocols were established. In the 1990s, the rehabilitation protocols were advanced further to allow athletes an early return to sports.  Today, while there is less variability in the surgical techniques used, there remains variability in the types of surgical grafts used.

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