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T he anterior cruciate ligament (ACL) is one of the most important stabilizers of the knee (1). Although magnetic resonance imaging (MILl) unquestionably is the most accurate noninvasive method for evaluating this ligament, at least five indirect plain radiographic signs indicating ACL injury have been described. Many, if not most, patients with an ACL tear will have normal plain radiographs, but radiologists should be able to recognize those subtle findings that indicate ligamentous injury. In this article, we will review the normal anatomy and function of the ACE, mechanisms of injury, and plain radiographic signs ofligamentous injury. We will also discuss ACL repair principles and complications.

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