The Tape Locking Screw technique (TLS): A new ACL reconstruction method using a short hamstring graft

The Tape Locking Screw (TLS(®)) system, developed in 2003, is a new anterior cruciate ligament (ACL) reconstruction method that is based on three principles: one hamstring tendon is harvested, prepared into a short (50 to 60mm), four to five strand closed loop, with a diameter of 8 to 10mm and a 500N pre-load; the tunnels are shorter than usual (10 or 15mm) and created in a retrograde manner to match the diameter of each end of the graft. Maximum press-fit into the bone recesses is obtained by a specific graft introduction method; femoral and tibial fixation is provided by polyethylene terephthalate tape strips, or TLS(®) strips, that pass through each end of the closed tendon loop and attach to bone with a dedicated interference screw, the TLS(®) screw. Our preliminary clinical evaluation consisted of a follow-up of 134 patients.