Over the past 4 years a trend towards repair of ACL Sherman type 1 has gained interest. The advantages of avoiding donor site morbidity and better proprioception are talked about. The strength of the repair with fibre wire sutures is less clear. Supplementing the repair with fibre tape augmentation has been discussed. if too tight to protect the repair the stress on the tape will invariably tear it causing IA reaction and a bit loose to avoid stress shielding by experts defeats its purpose.
What we clearly do is slower rehab to hopefully avoid repair failure? Microfracture at the femoral attachment to enhance repair are being touted.
Time will tell if we are going in the right direction. one month post repair mri shows a taut healing graft
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