Arthrex - ACL Repair

There has been a renewed interest in ACL primary repairs as the treatment for Sherman type I and type II ACL ruptures. Careful analysis of historical data has revealed that certain ACL tear subgroups, especially proximal tears with good tissue quality, have positive clinical outcomes with primary ACL repair.¹

Studies reporting outcomes of remnant-preserving ACL surgeries have shown encouraging results with a higher potential for early healing and better functional outcomes compared with remnant-resecting surgeries.² Preservation of the native ACL using primary repair technique can achieve short-term clinical success in a carefully selected subset of patients with proximal avulsion-type tears and excellent tissue quality. Primary repair has resulted in good clinical outcomes at 3-year follow-up in this carefully selected patient population.³

Arthroscopic primary repair is a conservative approach in that no grafts need to be harvested, no tunnels need to be drilled, and revision surgery, if necessary, is more analogous to primary reconstructions.⁴ The goal of the procedure is to preserve the remnant native ligament. By doing this, the native nerve endings and blood supply are preserved.⁵

^References

^{1. van der List JP, DiFelice GS. Role of tear location on outcomes of open primary repair of the anterior cruciate ligament: a systematic review of historical studies. Knee. 2017;24(5):898-908. doi:10.1016/j.knee.2017.05.009}

^{2. van der List JP, DiFelice GS. Successful arthroscopic primary repair of a chronic anterior cruciate ligament tear 11 years following injury. HSS J. 2017;13(1):90-95. doi:10.1007/s11420-016-9530-8}

^{3. Jonkergouw A, van der List JP, DiFelice GS. Arthroscopic primary repair of proximal anterior cruciate ligament tears: outcomes of the first 56 consecutive patients and the role of additional internal bracing. Knee Surg Sports Traumatol Arthrosc. 2019;27(1):21-28. doi:10.1007/s00167-018-5338-z}

^{4. DiFelice GS, Villegas C, Taylor S. Anterior cruciate ligament preservation: early results of a novel arthroscopic technique for suture anchor primary anterior cruciate ligament repair. Arthroscopy. 2015;31(11):2162-2171. doi:10.1016/j.arthro.2015.08.010}

^{5. DiFelice GS, van der List JP. Arthroscopic primary repair of proximal anterior cruciate ligament tears. Arthrosc Tech. 2016;5(5):e1057-e1061. doi:10.1016/j.eats.2016.05.009}

Surgical Technique Videos (9)
- - QuadLink™ ACL Reconstruction Using the QuadPro™ Harvester and FiberTag^® TightRope^® Implants
  - File Type:
  - Ref. #: VID1-002245-en-US
  - Version: A
  - Language: English
  - Revision Date: 04/30/2021
  - Presenter: John W. Xerogeanes, MD
  - Share
- - ACL Preservation With the TightRope^® Fixation System
  - File Type:
  - Ref. #: VID1-000112-en-US
  - Version: C
  - Language: English
  - Revision Date: 08/02/2019
  - Presenter: Michael P. Bradley, MD, MS
  - Share
- - ACL Primary Repair With InternalBrace™ Ligament Augmentation and AlloSync™ Demineralized Bone Matrix Augmentation
  - File Type:
  - Ref. #: VID1-000101-en-US
  - Version: A
  - Language: English
  - Revision Date: 06/21/2019
  - Presenter: Patrick A. Smith, MD
  - Share
- View More 3
- View All
Surgical Technique Animations (1)
- - ACL Preservation With the SwiveLock^® ACL Repair Kit
  - File Type:
  - Ref. #: AN1-000224-en-US
  - Version: A
  - Language: English
  - Revision Date: 11/09/2020
  - Share
Surgical Technique Guides (2)
- - SwiveLock^® ACL Primary Repair Implant System
  - File Type:
  - Ref. #: LT1-000174-en-US
  - Version: C
  - Language: English
  - Revision Date: 10/29/2020
  - Share
- - ACL Primary Repair With InternalBrace™ Ligament Augmentation
  - File Type:
  - Ref. #: LT1-00060-EN
  - Version: C
  - Language: English
  - Revision Date: 07/25/2019
  - Share
Presentation Videos (7)
- - InternalBrace™ Ligament Augmentation in ACL Repair and Reconstruction
  - File Type:
  - Ref. #: VID1-000980-en-US
  - Version: B
  - Language: English
  - Revision Date: 08/31/2020
  - Presenter: Patrick A. Smith, MD
  - Share
- - ACL Repair with InternalBrace™ Ligament Augmentation
  - File Type:
  - Ref. #: VPT1-00980-EN
  - Version: A
  - Language: English
  - Revision Date: 04/02/2018
  - Presenter: Wiemi A. Douoguih, MD
  - Share
- - Primary Anterior Cruciate Ligament (ACL) Repair with InternalBrace™ Ligament Augmentation
  - File Type:
  - Ref. #: VPT1-01013-EN
  - Version: B
  - Language: English
  - Revision Date: 02/19/2018
  - Presenter: Wiemi A. Douoguih, MD
  - Share
- View More 3
- View All
Patient Education Animations (1)
- - ACL Primary Repair Using the TightRope^® RT Implant With InternalBrace™ Ligament Augmentation
  - File Type:
  - Ref. #: pAN1-00372-EN
  - Version: A
  - Language: English
  - Revision Date: 09/18/2019
  - Share
Posters (1)
- - ACL Preservation: Early Results of A Novel Arthroscopic Technique of Suture Anchor Primary ACL Repair
  - File Type:
  - Ref. #: N/A
  - Version: N/A
  - Language: English
  - Revision Date: 05/13/2015
  - Share
Coding Guides (1)
- - 2021 Coding and Reimbursement Guidelines for SwiveLock^® ACL Repair Kit
  - File Type:
  - Ref. #: OF1-000345-en-US
  - Version: A
  - Language: English
  - Revision Date: 02/17/2021
  - Share
Outcomes Reports (1)
- - ACL Repair with InternalBrace™ Ligament Augmentation
  - File Type:
  - Ref. #: CC1-00025-EN
  - Version: E
  - Language: English
  - Revision Date: 07/02/2020
  - Share
Scientific Updates (1)
- - ACL Primary Repair Scientific Update - A Review of Modern Techniques
  - File Type:
  - Ref. #: LA1-00055-EN
  - Version: K
  - Language: English
  - Revision Date: 12/03/2020
  - Share
SOS Graphs (2)
- - ACL Repair with InternalBrace™ Ligament Augmentation
  - File Type:
  - Ref. #: DOC1-000239-en-US
  - Version: A
  - Language: English
  - Revision Date: 07/07/2020
  - Share
- - ACL Repair with InternalBrace™ Ligament Augmentation vs. ACL Reconstruction up to Two Years Follow-up
  - File Type:
  - Ref. #: DOC1-000178-en-US
  - Version: B
  - Language: English
  - Revision Date: 01/15/2020
  - Share
Testimonials (3)
- - ACL Preservation: A Unique Case Report of ACL Primary Repair With InternalBrace™ Ligament Augmentation
  - File Type:
  - Ref. #: VID1-000619-en-US
  - Version: A
  - Language: English
  - Revision Date: 01/28/2020
  - Presenter: Gregory S. DiFelice, MD
  - Share
- - ACL Primary Repair with InternalBrace™ Ligament Augmentation Gets Runner Back on the Trail
  - File Type:
  - Ref. #: VID1-000009-en-US
  - Version: A
  - Language: English
  - Revision Date: 01/10/2019
  - Share
- - Alpine Skier Makes an Olympic Comeback Thanks to Arthrex Innovation
  - File Type:
  - Ref. #: VID1-01464-EN
  - Version: A
  - Language: English
  - Revision Date: 12/26/2018
  - Presenter: Bertrand Sonnery-Cottet, MD
  - Share
Video Series (2)
- - BreakThrough™ with Christopher Adams, MD - Episode 10: ACL Primary Repair
  - File Type:
  - Ref. #: VID1-01331-EN
  - Version: B
  - Language: English
  - Revision Date: 04/25/2018
  - Presenters: Christopher Adams, MD, Gregory S. DiFelice, MD, Bertrand Sonnery-Cottet, MD, Wiemi A. Douoguih, MD
  - Share
- - BreakThrough™ with Christopher Adams, MD - Episode 10: ACL Primary Repair
  - File Type:
  - Ref. #: VID1-01332-EN
  - Version: A
  - Language: English
  - Revision Date: 04/20/2018
  - Presenter: Christopher Adams, MD
  - Share
Case Presentation Videos (1)
- - NanoScope™ Operative Arthroscopy System - ACL Repair of a Femoral Avulsion in a Young Adult
  - File Type:
  - Ref. #: VID1-000762-en-US
  - Version: A
  - Language: English
  - Revision Date: 06/03/2020
  - Presenter: Thomas M. DeBerardino, MD
  - Share