Anterior Cruciate Ligament (ACL) Primary Repair

ACL rupture occurs in hundreds of thousands active adolescents and young adults each year. While many ACL tears are treated extremely well with standard ACL reconstruction, the pain and morbidity associated with graft harvest and length of time to full recovery from surgery remains an area that both athletes and surgeons wish to improve. In addition, arthritis development is commonplace within a decade of injury in these young patients treated with standard ACL reconstruction. Primary repair of the ACL offers advantages when compared to traditional ACL reconstruction. Historically, the technique of primary ACL repair was largely abandoned by the mid 1990’s due to marginal clinical outcomes and the thought that the ACL has poor potential to heal. However, careful analysis reveals that certain subgroups, especially proximal tears with good tissue quality, had better clinical outcomes than the group as a whole. In light of the advances in diagnostic imaging, arthroscopic surgical technology and rehabilitation approaches that have come to fore over the past several decades, primary ACL repair is an emerging concept that is great alternative for select patients. Primary repair has significant potential advantages over current ACL reconstruction techniques, including the preservation of the complex attachment sites and innervation of these structures, thus retaining much of the biomechanical and proprioceptive function of these tissues. More specifically, modern MRI imaging can know preoperatively identify those tears that are amenable to repair. Surgical instrumentation now exists that allows anatomic restoration of the normal ACL with robust fixation to allow aggressive rehabilitation.

Figure 1. Sutures in stump of torn ACL.

Figure 2. ACL repaired with suture anchors . ACL is restored to normal anatomy and the ACL tissue quality is excellent.

Below is a video of Dr. Ahmad performing an ACL primary repair.

If you wish to have an evaluation and see if you are candidate for Primary ACL Repair, click here to contact Dr. Ahmad’s office.

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© 2018 Christopher S. Ahmad, MD

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