Description
In this informative presentation, Dr. Bruce Reider discusses the historical and contemporary perspectives on ACL primary repair, a surgical technique for repairing torn anterior cruciate ligaments. He begins by reflecting on his honor to be part of the British Orthopedic Sports Trauma and Arthroscopy Association's virtual meeting and expresses his desire to participate in person in the future.
Dr. Reider traces the origins of ACL repair back to 1938 with Ivor Palmer's monograph, which highlighted the need for surgical intervention since spontaneous healing of ruptured ligaments is rare. He recounts the contributions of orthopedic pioneers like Don O'Donoghue and John Marshall, who practiced ACL primary repair, and discusses the evolving opinions on its efficacy over the decades, particularly as evidence from various studies suggested that outcomes often deteriorated over time.
The presentation covers advancements in repair techniques, including hybrid approaches that incorporate remnant preservation, and innovative methods like the BEAR (Bridge-Enhanced ACL Repair) technique developed by Dr. Martha Murray, which uses a collagen-based implant to support the repair. Other techniques mentioned include meticulous suture methods and a dynamic stabilization approach developed in Switzerland.
Dr. Reider emphasizes the need for long-term data to assess the true effectiveness of these new methods, noting that despite promising short-term results, they must be validated with extended patient follow-ups. He concludes with insights into the ongoing debate within the orthopedic community regarding the viability of primary repair compared to reconstruction and advises cautious optimism until more comprehensive data is available.