Primary Anterior Cruciate Ligament Single-Bundle Repair With Augmentation for a Partial Anterior Cruciate Ligament Tear

Although anterior cruciate ligament (ACL) reconstruction remains the gold standard for the treatment of ACL tears, repair is regaining popularity as a treatment option for proximal or distal ACL avulsions. Historically, ACL repairs had poor outcomes. To remedy this, techniques were developed using graft-based augmentation but never gained widespread popularity. Recently, there has been a renewed interest in primary ligament repairs, with newer techniques incorporating modern synthetic materials to augment the repair site. The term “internal bracing,” or ligament repair with augmentation, has been used to describe the new philosophy for primary ligament repair and augmentation. We present our technique for arthroscopic primary ACL repair with augmentation for a proximal posterolateral bundle tear. The advantages of this technique include preservation of the intact fibers of the anteromedial bundle, intuitive suture augmentation with standard ACL tunnel placement techniques, and the ability to calibrate ligament tension.