Initial repair of the anterior cruciate ligament.
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Primary ACL Repair
Primary ACL repair is performed in cases of acute ligament injuries, where there is still healthy tissue that can be repaired. This type of repair may be an option for young, active patients.
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Primary ACL repair is a surgical procedure to repair a torn or injured anterior cruciate ligament (ACL) at or near its bone attachment. It involves using stitches and a plastic anchor to reattach the torn ACL to the bone. In some cases, a strong stitch acts as an internal brace to protect the healing ligament. This is different from a traditional ACL reconstruction, which uses a tissue graft to create a new ACL. Repair is usually not possible if the tear is in the center of the ligament.
Anatomy, Indications, and Preparation
The ACL is a major stabilizing ligament in the knee, running from the femur (thigh bone) to the tibia (shin bone), and it prevents the tibia from sliding forward. An ACL injury, which is the main indication for this procedure, often occurs during sports that involve pivoting and cutting movements, or from a direct blow to the knee. An ACL tear may be accompanied by a loud popping sound, the feeling of the knee buckling, and swelling. Preoperative preparation includes a physical exam, blood work, and imaging. Patients are advised to stop taking blood thinners and to avoid food and liquids for at least 8 hours before surgery.
Surgical Procedure
Primary ACL repair is typically performed using a minimally invasive arthroscopic technique under general anesthesia. The surgeon makes small incisions around the knee, inserts an arthroscope to view the joint, and performs the repair.