**5. The evolution of ACL reconstruction**

Before the early 1990's most of the ACL reconstruction were performed through medial arthrotomy which became with time mini arthrotomy. However, arthroscopic reconstruction (Paulos et al., 1991) undergone rapid development. Although achievement of stability has been well-documented in open ACL reconstructive procedures, it quickly appeared arthroscopically assisted ACL reconstruction offered significantly diminished morbidity, and more predictable rehabilitation after surgery. Improvements in instrumentation allowed refining the precision of the technique.
