Rotational control of the knee was long thought to be secondary to the ACL alone. Recent works have shown that it is not that simple. In this article, we demonstrated that the ACL alone does not control rotation of the knee, and instead works in concert with the anterolateral structures, especially the anterolateral ligament. We found that in order to get the presence of a pivot shift on exam, an injury to the ACL and ALL are required. This provided significant insight into the biomechanics of the knee.

ACL-Deficient Knee Anterolateral Structures