Management of the patient with an ACL-deficient knee continues to be controversial. In the patient with an acute ligament disruption, arthroscopic examination if employed should be followed by a physical therapy program that restores not only range of motion and strength, but also prepares the athlete for the return to his sport. Patients with chronic ACL-insufficiency must be evaluated meticulously with regard to pain and instability with functional activities followed by a vigorous attempt at conservative care including bracing.