Reconstruction vs. repair: a review of recent trends and controversies for management of ACL rupture

Anterior cruciate ligament (ACL) repair has become increasingly popular in recent years as an option for management of ACL rupture. Though arthroscopic reconstruction has long been the gold standard, there may be a role for repair in appropriately selected patient populations and tear patterns. Recent industry-driven advances in techniques and available instrumentation for ACL repair have regenerated interest. Proponents of ACL repair highlight the maintenance of native tissues allowing for retained proprioception, lack of need for graft usage or harvest, and the potential for accelerated rehabilitation postoperatively as compared to ACL reconstruction. Short-term and early mid-term ACL repair studies have demonstrated encouraging results; however, the authors remain in favor of ACL reconstruction at this time given a dearth of long-term outcomes following ACL repair.