Background. Damage to the cruciate ligaments of the knee, despite progress in diagnostics and constantly improved treatment methods, is still a major challenge for orthopedics. In ca. 90% of cases the anterior cruciate ligament (ACL) is damaged, often with collateral damage to other joint structures, such as the meniscus and the articular cartilage; in some cases, the lateral fibular ligament is also damaged, additionally complicating the situation. The goal of treatment is to restore the physiological condition of the knee joint (stability, full mobility, pain-free). Thus conservative treatment is aimed at improving the active functions of the knee stabilizers. Surgical treatment presently involves endoscopic reconstruction of the ligament, single- or multi-channel, using free ST and GR grafts and the proper patellar ligament. Physiotherapy is an integral and vital element of treatment. Early, preoperative rehabilitation is particularly important. Material and methods. 300 endoscopic ACL reconstructions were performed in the Department of Orthopedics and Knee Surgery at the EuroMediCare Hospital in Wrocław, Poland, from January 2002 to August 2004, using primarily free ST and GR grafts. After surgery the patients received a standard 25-week rehabilitation program.Results. We achieved 80% excellent or good outcomes, 15% satisfactory outcomes, and 5% poor outcomes.Conclusions. The most effective method for treating ACL damage is endoscopic reconstruction. Proper rehabilitation is an extraordinarily important element of treatment: there is no modern knee surgery without modern rehabilitation.