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Updated: May 15, 2026

Surgical Retrieval, Isolation and In vitro Expansion of Human Anterior Cruciate Ligament-derived Cells for Tissue Engineering Applications
Published on: April 30, 2014
[Repair of proximal anterior cruciate ligament tears and internal brace augmentation : Technical note]
Louisa Bell1, Christian Egloff2,3
1Abteilung Kniechirurgie, Schulthess Klinik, Lengghalde 2, 8008, Zürich, Schweiz.
Objective:
Refixation of anterior cruciate ligament (ACL) tears and augmentation using an Internal Brace® (Arthrex Inc., Naples, FL, USA) has become increasingly popular in recent years. The aim is to preserve the native ligament structure and, thus, improve clinical outcomes.
Indications:
Indications are proximal ACL tears of Sherman type I and II in the acute phase postinjury. For multiligament injuries, internal brace augmentation can contribute to increased joint stability.
Contraindications:
ACL refixation is not recommended for distal or middle segment tears and should not be delayed for more than 4 weeks posttrauma to ensure adequate healing.
Surgical Technique:
The rupture is bridged by an ultrahigh-molecular-weight polyethylene tape to reattach the ACL to the femoral footprint.
Postoperative Management:
Functional postoperative treatment involves partial weight-bearing of 15 kg on crutches within 3 weeks postoperatively. High-impact activities should be avoided for the first 6 months postoperatively.
Results:
The clinical results of ACL augmentation with an Internal Brace® show a slightly increased re-rupture rate compared to ACL replacement, with good to excellent functional outcomes.
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