Bridge-Enhanced Anterior Cruciate Ligament Repair: the Next Step Forward in ACL Treatment.

Anterior cruciate ligament (ACL) injuries are common in young and active patients. In this patient population, surgical treatment with an autograft tendon is recommended to reconstruct a new ACL. ACL reconstruction has a high patient satisfaction, improved patient reported outcomes and allows young patients to return to an active lifestyle, including sports. However, long-term follow-up shows these patients are at higher risk for degenerative arthritis, frequently at a young age. Recent research has focused on re-investigating the utility of performing an ACL repair rather than a reconstruction in the hopes that maintaining a patient's native ligament may not only restore knee stability, but provide improved knee kinematics and lessen the risk of late osteoarthritis and also limit donor site morbidity from autograft harvests. Historically, patients undergoing ACL repair suffered poor outcomes due to issues with intra-articular healing of the ligament; but now, with new bioengineering techniques, bridge-enhanced ACL repairs may provide a feasible alternative in the treatment of ACL injuries.