Editorial Commentary: Back to the Past-Anterior Cruciate Ligament Repair Revisited

There has been increasing scientific interest in primary anterior cruciate ligament (ACL) repair in recent years. The results of these procedures have improved significantly compared with the 1970s and 1980s. Nevertheless, the overall rerupture rates after ACL repair are worse than after ACL reconstruction, and patient-reported outcome measures do not improve after ACL repair, in contrast to those after ACL reconstruction. However, because primary ACL repair is performed in the acute phase, improvement in patient-reported outcome measures after surgery is not expected. We believe that in the future, primary ACL repair will be established next to ACL reconstruction and nonsurgical therapy. One possible indication is a proximal ACL rupture. Which surgical technique will prevail-and whether orthobiological treatments such as platelet-rich plasma or stem cells will improve postoperative outcomes after ACL repair-will need further clarification by clinical trials.