Surgical therapy of anterior cruciate ligament injuries: reconstruction or primary repair and InternalBraceTM augmentation? A narrative review

While the beginnings of Anterior Cruciate Ligament (ACL) surgery comprised the direct suture of the torn ligament via an invasive arthrotomy, this approach has been swiftly abandoned because of high complication and re-rupture rates. Today, the gold standard is arthroscopic ACL reconstruction using autologous tendon material. However, although this technique results in reproduceable good outcomes, several postoperative complications such as graft harvesting site morbidity, anterior knee pain and quadriceps weakness have been reported. Recent technical developments in arthroscopic surgery have therefore resurrected the interest in primary ACL repair. While good clinical outcomes after primary ACL repair and InternalBrace TM augmentation have been reported, supporting evidence for the functional benefit of this technique is still missing.