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Anterior Cruciate Ligament Repair
Dr. James Chen, M.D. - In San Francisco, CA



Dr. Chen's surgical technique for ACL Repair


Some types of tears of the Anterior Cruciate Ligament (ACL) can be repaired rather than reconstructed. When the ligament is torn off of its origin (femoral avulsion) or its insertion (tibial avulsion), it can be repaired. The advantage of a repair is that it leaves the native ligament in place and there is a quicker recovery with fewer restrictions because there is no need for a lengthy ligament revascularization process that is typical of a reconstruction. In an ACL repair, two small incisions are made on the front of the knee. An arthroscopic camera and instruments are used to place sutures in the ACL. Biocomposite implants are used to anchor the ligament to bone.

Common Questions about Anterior Cruciate Ligament Repair

What is an ACL repair?

An ACL repair is when the native ACL is sewed and anchored into its origin or insertion. This is in contrast to a reconstruction in which a new ACL is inserted into the knee. An ACL repair, when possible, is more desirable than a reconstruction because it uses the patient’s own native ACL and shortens the rehabilitation time by half.

When can an ACL be repaired?

When the ACL is torn off of one end or the other and the ACL tissue is healthy appearing then the patient is a candidate for repair of the native ACL. If it is torn in the middle of the ligament or if the ligament tissue is not healthy then it cannot be performed.

How is an ACL repair performed?

An ACL repair is performed arthroscopically through 4.5 mm incisions with instruments. Suture is used to sew the ACL which is then anchored into the bone with a bioabsorbable anchor.

How long does ACL repair take?

ACL repair done arthroscopically takes 1 to 2 hours.

What are some complications of ACL repair?

Sometimes the repaired ACL does not heal and it ruptures prematurely. This indicates that the ACL tissue was not healthy enough to serve as a functional ACL.

What is ACL repair recovery like?

Recovery from ACL repair is similar to recovery after ACL reconstruction except it takes half the time. The patient uses crutches for 2 weeks and a hinged knee brace for 6 weeks. Physical therapy is recommended weekly until the patient returns to full activity. The patient progresses from stationary bike to jogging to sports in 4 to 6 months.

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