Internal Bracing of the Anterior Cruciate Ligament and Posterior Cruciate Ligament with Suture Tape Augmentation

The anterior cruciate ligament (ACL) is the primary restraint to anterior tibial translation of the knee, and the posterior cruciate ligament (PCL) is the primary restraint to posterior tibial translation of the knee. ACL reconstruction with hamstring or patellar tendon autograft has been the gold standard surgical option for ACL ruptures for many years. Injuries to the PCL in isolation are rare and often managed conservatively although most PCL injuries occur in the multiligament knee injury setting where surgery is indicated, most commonly with a PCL reconstruction. In addition, operative management is indicated in Grade III PCL tears and chronic tears which are symptomatic. ACL and PCL repair techniques have been described in previous literature with variable results. Internal bracing with suture tape augmentation acts as a secondary stabiliser, encouraging natural healing and allowing early mobilisation. This chapter describes internal bracing of the ACL and PCL with suture tape augmentation.