Primary ACL Repair

The anterior cruciate ligament (ACL) is a ligament in the center of the knee that functions as an important knee stabilizer. It is one of the most injured ligaments in the knee. ACL injuries occur approximately 70% of the time without any form of physical contact. The majority of the time, they happen during pivoting motions, poor landings, or sudden acceleration or deceleration. Although reconstruction is largely acknowledged as the gold standard treatment option for ACL injuries, many patients continue to have problems, including graft failure, inability to return to sporting activities, and the development of arthritis. More than a century ago, primary ACL repair was documented, but due to the state of research at the time and perceived disappointing results, it was abandoned. During the last decade, there has been a renewed interest in preserving ACL in order to avoid some of the consequences associated with its reconstruction. Promising results in a clearly defined subset of patients have been documented in recent trials. Repair of the ligament has potential advantages over reconstruction of the ligament, such as decreased surgical morbidity, faster return of range of motion, and minimally invasive surgery. This presentation will focus on primary ACL repair, assess the indications, and describe the techniques.