Anterior Cruciate Ligament (ACL) Tears: ACL Repair Using a Suture Implant Animation

Anterior Cruciate Ligament (ACL) Tears: ACL Repair Using a Suture Implant Animation

This animation demonstrates an ACL repair for the treatment of an ACL tear. When an ACL tear is closer to where the top of the ligament attaches to the femur, or thigh bone, it can be repaired by being reattached to the bone. In cases where the ACL tears farther down the ligament, reconstruction with a tendon graft is often required.

Here, we see inside a right knee with the ACL torn off from the thigh bone. First, a pin is drilled into the location where the ACL was attached to create a tunnel through the bone. A blue and white looped suture is passed through the tunnel and tied out of the way.

Next, a passing suture implant is placed through the top of the ACL with a suture-passing instrument. Once tightened, it creates a luggage tag ring around the ACL. The suture end is cut, leaving two free ends. The ACL is then prepared with an adjustable suture device from a product card. The number one suture is threaded through the opening in the passing suture end, and the opposite end is pulled to pass the suture through the ACL and back out.

The striped suture is cut, leaving the white loop. The number two suture from the card is passed through the number one suture loop and then back through the metal loop on the card. Pulling the blue tab threads the sutures through the adjustable suture device, creating a double loop that is passed through the ACL tissue.

All sutures are removed from the card. These include a small metal button that will sit outside the thigh bone and flat support sutures that can be used to reinforce the ACL. Next, a pin is drilled through the tibia, or shinbone, to create a tunnel. A wire loop is inserted through the pin and set aside.

The adjustable suture device sutures are threaded through the blue and white looped suture in the thigh bone and pulled into the tunnel. The metal button is flipped to rest on the outside of the thigh bone. The white tensioning sutures are pulled individually to reattach the ACL securely to the bone.

The flat support sutures are passed through the wire loop in the shinbone and secured with a hard-body anchor. Final tension is applied to the ACL repair sutures, completing the procedure.