Tears of the anterior cruciate ligament (ACL) are most commonly caused by having the upper-leg displaced backwards or sideways by impact, while the lower leg is in a stable position.

Reconstruction of the anterior cruciate ligament is required to restore its function following damage to it. The ligament itself cannot be repaired, and so a replacement is typically grafted. A patellar tendon graft involves the removal of the middle section of the patellar tendon, along with attached plugs of bone on each end. A single tunnel into the tibia and fibula bones is made. The damaged ligament is extracted, and the replacement ligament is brought through the bones, sometimes being replaced by screws.

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