The anterior cruciate ligament (ACL) is frequently ruptured in pivoting athletes and is the most frequently reconstructed ligament. The clinical outcome is, in general, very good; however, there is still a significant number of failures after ACL reconstruction, and not all athletes are able to return to sport following ACL reconstruction. The lateral extra-articular procedures may have decreased the re-rupture rate; however, biomechanical studies suggest this may increase joint reaction forces within the tibiofemoral joint, and the long-term outcome of these combined procedures is pending. We suggest a more nuanced approach to concomitant procedures via identifying and addressing the injured primary and secondary stabilizers of anterior translation and internal rotation, akin to the Lyon Knee School menu à la carte for the correction of patellofemoral instability. The goal of this review is to examine the biomechanics of the knee regarding primary and secondary stabilizers of anterior translation and internal rotation in the knee. Secondarily, we suggest how to assess these structures in the clinical and radiographic work-up of the injured knee. The aim of this chapter is to present a biomechanical and clinical rationale for a menu à la carte personalized approach for ACL surgery.