The combination of the greater susceptibility and a 10-fold increase in the female sports population since the inception of Title IX has resulted in a dramatic increase in the number of ACL injuries in females. In the United States, 100,000 to 300,000 total ACL injuries occur each year. The treatment costs exceed $1 billion annually in female varsity athletics alone and do not end with the ACL reconstruction and rehabilitation. A strong association exists between ACL injury and development of posttraumatic knee osteoarthritis at a relatively young age, which also occurs with much greater incidence in females than males.