Anterior Cruciate Ligament Anatomy –A Review of the Anteromedial and Posterolateral Bundles

Critical evaluations of anterior cruciate ligament (ACL) reconstruction failure modes have shown that the most common cause for failure is aberrant femoral tunnel placement. Regardless of the surgical reconstruction technique, it is imperative to have a thorough understanding of the anatomy and function of the anteromedial (AM) and posterolateral (PL) bundles of the native ACL to successfully restore the stability and motion of the injured knee. Similar to the observation that anatomic reduction is critical to successful fracture management, ACL reconstruction techniques must focus on restoring the normal anatomy of the ACL. This article reviews the anatomy of the AM and PL bundles of the ACL, including landmarks for identifying their femoral and tibial footprints.