Arthroscopic Primary Repair of the Cruciate Ligaments

Abstract Primary repair has been increasingly advocated for the treatment of proximal and distal anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tears. Because of modern developments in preoperative imaging, arthroscopic surgery and rehabilitation, excellent outcomes of primary repair have been reported when applied to a select group of patients. The theoretical advantages of primary repair are mainly related to the minimally invasive nature of the surgery compared with ACL reconstruction, including preservation of native tissues, avoidance of graft harvesting and not burning any surgical bridges for reconstruction in case of reinjury. Several studies have reported the results after primary repair of the cruciate ligaments. In this chapter we discuss the (1) indications and patient selection, (2) treatment algorithm, (3) surgical techniques, (4) rehabilitation and (5) outcomes of modern-day arthroscopic repair. Finally, (6) future directions of primary repair of the cruciate ligaments are discussed.