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The ACL prevents the tibia from moving too far forward in relation to the femur, and tears can cause knee instability. Various tests, such as the anterior drawer test and Lachman test, are used to diagnose ACL tears. The anterior drawer test is done with a bent knee, while the Lachman test is more reliable and performed with the knee slightly flexed. The pivot shift test, done in knee extension, assesses the ACL but can be challenging due to guarding. A clunk at 20-30 degrees indicates an ACL tear.