Purpose <p>This study aims to investigate the relationship between increasing internal tibial torque (ITT) and the distribution of stress on the anterior cruciate ligament (ACL), with a focus on identifying the location of tear initiation and propagation. In particular, the study emphasizes the femoral enthesis as a potential site of geometric vulnerability during pivot landing.</p> Methods <p>A three-dimensional finite element model of the ACL was developed and combined with an extended finite element method framework to simulate tear initiation and propagation. The model was driven by torque-indexed, three-dimensional knee kinematics obtained from previous <i>in silico</i> knee simulations that were validated against <i>in vitro</i> cadaveric knee tests (15 specimens). ITT was applied in graded steps to reproduce pivot landing–relevant internal rotation loading. Stress/strain fields were evaluated, and tear initiation/propagation were tracked to quantify damage evolution.</p> Results <p>Maximum von Mises stress increased proportionally with ITT and localized near the femoral enthesis, with a mean increase of 26.56% for each 5Nm increase in torque. Stress concentration consistently occurred at the posterolateral bundle attachment on the femoral side, where tear initiation was predicted. With further ITT increases, the tear propagated from the femoral enthesis, indicating a torque-dependent damage progression mechanism.</p> Conclusion <p>Increased ITT produced reproducible stress/strain concentration at the femoral enthesis, supporting structural vulnerability during pivot landing. This approach extends stress-only analyses by predicting rupture initiation and tear progression. These findings may inform prevention and rehabilitation by highlighting the roles of ITT and femoral insertion morphology in ACL tear initiation and propagation.</p>