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What did I do?
I aimed to understand the potential role of arthroscopic primary repair of the anterior cruciate ligament (ACL) in the current treatment algorithm of ACL injuries. We currently have an ‘all or nothing’ approach in which we either treat patients conservatively or treat them surgically with an ACL reconstruction. Although ACL reconstruction has been proven successful in restoring instability, this treatment is relatively invasive with graft harvesting and corresponding donor site morbidity, tunnel drilling, difficult rehabilitation and complicated revision surgery with tunnel malpositioning and widening and the unavailability of grafts. Therefore, I investigated in this PhD whether arthroscopic ACL repair can be another treatment option in addition to this ‘all or nothing’ approach in selected patients.
Why did I do it?
Primary ACL repair was commonly performed in the 1970s and 1980s, but fell out of favour as several randomised trials showed better results with ACL reconstruction versus ACL repair. However, at the end of the ACL repair era, it had been noted that primary repair might be better in patients with proximal avulsion tears rather than midsubstance tears, but this …
Footnotes
Contributors JPvdL has been responsible for all the work in this submission, and accepts full responsibility for the finished work.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.