Abstract
T he purpose of this article is to discuss the current knowledge on the etiology of anterior cruciate ligament (ACL) injury, particularly with regard to definition and classification of contact and noncontact injuries. In 2008, Scott McLean presented a keynote presentation at ACL Research Retreat IV entitled ‘‘The ACL Injury Enigma: We Can’t Prevent What We Don’t Understand.’’1 Dr McLean’s commentary addressed modifiable neuromuscular ACL risk factors, particularly the need to accelerate the exchange between the laboratory and the sports field (arguably still our most pressing area). Today, I believe his words resonate in a deeper sense than possibly he ever intended. To our detriment, we have invested 2 decades and millions of dollars in research into the problem of noncontact ACL injury without defining in clear and unambiguous language what we mean by noncontact ACL injury. Although this research effort has clearly been far from wasted, I predict future investigations would benefit from a more focused and detailed description of the causes of ACL injury.
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