Arthroscopy Primary Double-Bundle Repair of Anterior Cruciate Ligament With Internal Brace Augmentation and a Knotless Anchor Implant

The primary repair technique of acute anterior cruciate ligament (ACL) tears has been controversially discussed over the past few decades. Many different suture techniques have been reported for ACL repair, but these procedures showed high re-rupture rates and poor results. Recently, the literature has reported excellent outcomes with primary ACL repair. There has been a resurging interest in modernizing and augmenting primary ACL repair. This article describes a technique that uses internal brace augmentation and a knotless anchor (Arthrex) implant for primary anatomic double-bundle ACL repair after an acute proximal ACL tear. This technique aims to advocate natural healing by the high-strength internal brace augmentation and knotless anchor as a provisional scaffold during the healing phase and early mobilization. This technique might be an alternative to conventional ACL reconstruction in the appropriate selection of patients.