Anterior Cruciate reconstruction has come a long way in the last 20-30 years. It has become a predictable procedure to restore knee stability to a majority of patients.The current procedure that involves a graft is not perfect. According to Frank R. Noyes, MD, "the body of scientific evidence shows that 10% to 15% of patients have problems," including arthrofibrosis, crepitus, knee pain, and range of motion limitations. Teh actual sucess rate is still to be determined. Main reasons that Anterior Cruciate Ligament reconstruction has become more sucessful are technique and technology. The most significant technological advance is the arthroscope. This instument produces an image of the knee on a 19 inch television monitor. This allows the surgeon to have better vision and better placement for the graft. Changes in rehabilitation for ACL reconstruction has been the final step in making the surgery more successful. Due to lack of knowledge on ACL reconstruction procedures, patients are more reluctant in agreeing to surgery. The detection of ACL injuries can be very challanging because of frequent misdiagnosis. One study found that 77% of patients who had acute hemarthrosis of the knee also had a torn ACL. Diagnosis for a torn ACL is costly because it usually involves the use of an MRI. To avoid using an MRI, the best thing to do is to reduce swelling and have the patient return later for a physical exam. This method reduces the use of MRI to patients undecided about surgery. ACL reconstruction is not performed until after the onset of acute symptoms. Though the surgery is very successful, it does not restore normal stability and fuction. It does however, restore stability to the knee and gets the patient back to fuctional use of the joint. Arthritis is another important consideration in the treatement of ACL injuries. With a 10% to 20% risk of trauma ACL injuries are the number 1 arthrosis producing injury. Unless the knee is stabilized,sometimes with ACL reconstruction, arthritis can become seere in the knee joint. ACL reconstructions are not used to fix laxity in the knee but to stabilize a knee when the condition is potentially dangerous for the patient. There are three things that a patient can do with an ACL injury. they can either refrain for activity go through therapy, or surgery. Age is also a concern in ACL reconstruction. Most patients under the age of 30 are recommended for surgery because they heal fairly quick. Due to the incresed activity level of older people surgery is also becoming an option for them. People willing to refrian from strenuos activity may choose to use only rehab for treatment. Rehab is a crucial part of a successful ACLK reconstruction. One consideration of rehab is whether the patient has the time or motivation to complete treatment.Though rehab may be administered directly after surgery, the patient is not allowed to return to a twisting sport for 3-6 months depending on the physician. Doctors can help people decide whether or not to have srgery but can not assure the success of the reconstruction. There are many risks still involved because of insufficient long term data. However, the results are looking positive due to new technology. ACL reconstruction is definitely becoming an attreactive option for active people