Latest Innovations in ACL Surgery

17 years ago, I did something that got me ridiculed by my peers. I started repairing ACLs instead of reconstructing them. Today, I've successfully treated thousands of patients using this "controversial" approach. Here's why I made the switch (and more surgeons are considering): The Problem That Started It All: I was working in the Bronx, treating patients who were socioeconomically disadvantaged. ACL reconstruction is brutal. It requires:  • Months of intensive physical therapy  • Strong support networks  • Significant resources My patients didn't have these advantages. So I asked myself: "What if we could make this surgery less invasive?" The "Aha" Moment: New shoulder technology had just emerged—suture anchors and advanced stitching techniques. I thought: "Why not adapt these for the knee?" So I performed what I called "rotator cuff repair for the knee." The results were remarkable:  • Faster recovery  • Less morbidity • Durable outcomes The Evolution of My Approach: My treatment algorithm has evolved over 17 years: Phase 1: Reconstruct everyone Phase 2: Repair what I can, reconstruct the rest Phase 3: Repair what I can, augment when needed, reconstruct as last resort Phase 4: My current "Preservation First" approach—repair, use biologics like the Bear implant, augment, then reconstruct only when necessary The Numbers Tell A Story: In my current practice:  • 45-50% get ACL repair  • 10-15% get Bear implant treatment  • 20% get augmentation  • Only 20% need full reconstruction That means 4 out of 5 patients avoid the "big surgery." Why This Matters: The old teaching said ACLs can't heal because of "poor blood supply." That's wrong. When you have a Type 1 or 2 proximal tear (top 25% of ligament), there's plenty of blood supply and tissue to work with. Why remove healthy tissue when you can repair it? The Long-Term Results: My research team just submitted our 10-15 year follow-up on my first 18 patients: 16 patients available for follow-up with zero arthritis. Compare that to reconstruction, where 10-40% develop arthritis within 10-15 years. The Real Game-Changer: Biology The last few years have brought incredible advances in biologics: • ActivBraid suture (half collagen, half synthetic) - Zimmer Biomet • Ossiofiber suture anchors that integrate into bone - OSSIO • BEAR implants that help tissue regeneration - Miach Orthopaedics, Inc. Using my repair techniques with the BEAR implant, I can now repair midsubstance tears that I never thought possible. The Bottom Line: For 17 years, I've had colleagues question this approach, and say it is not possible. But when patients tell me "My knee feels normal" instead of "You did a good job, doc"—I knew I was onto something revolutionary. The future of ACL surgery isn't bigger, more complex reconstructions. It's preserving what nature gave us and helping it heal. #PreservationFirst #Trustthebody #SaveTheACL #ACLRepair #OrthopedicInnovation #SportsMedicine

🔬 New publication in Arthroscopy Techniques 🎯 The Quad 2.0 Technique: A Single Rectus Femoris Autograft Solution for Combined ACL and Double-Bundle ALL Reconstruction Proud to share our latest surgical innovation: the Quad 2.0 technique, using a single rectus femoris tendon autograft for anatomical reconstruction of both the anterior cruciate ligament (ACL) and the anterolateral ligament (ALL) — particularly suited for revision ACL surgeries. 💡 Why is it a breakthrough? • Avoids additional femoral/tibial tunnels for ALL • Preserves hamstring tendons • Reduces donor site morbidity and anterior knee pain • Effective in multiligament knee injuries • Optimizes valgus stability • Allograft-free revision strategy A precise, reproducible, and minimally invasive technique for challenging ACL cases. 📎 Open access article: https://lnkd.in/e7s98K_N With: Victor Sonnery-Cottet, Dany Mouarbes Ali Alayane MD, FEBOT ,Regis Pailhe #ACLreconstruction #Quad20 #ALLreconstruction #KneeSurgery #Orthopedics #SportsMedicine #Innovation #CHUToulouse #Cavaignac #Arthroscopy

🦵 High Return to Sport, Low Rerupture Rates After Augmented QT Autograft ACLR A new study in ASMAR (Lavender et al., 2026) reports encouraging mid‑term outcomes following all‑inside QT autograft ACLR augmented with bone marrow aspirate concentrate (BMAC), demineralized bone matrix (DBM), and suture tape augmentation (InternalBrace). 📊 Study Highlights: • 98 young, athletic patients (mean age 19 years) • Minimum 2‑year follow‑up (mean 3.4 years) • All cleared for return to sport at 6 months ✅ Key Outcomes: • 91.8% returned to pre‑injury activity levels • 3.1% graft rerupture rate • Mean IKDC: 84 • Mean ACL‑RSI: 93 (high psychological readiness) • Minimal pain (VAS <1) • Reoperation rate: 4.1% 🧠 Key Takeaways for Clinicians: 🔹 Biologic + mechanical augmentation may matter – The combination of BMAC, DBM, and InternalBrace may enhance graft healing and protect the reconstruction during early rehabilitation. 🔹 Early return to sport without penalty – Despite clearance at 6 months, rerupture rates remained low, contrasting with historical concerns around early RTS in young athletes. 🔹 Quad continues to perform well – QT autograft provided strong functional and psychological outcomes in a high‑risk population. 🔹 Contralateral injury remains a challenge – A 9.2% contralateral ACL tear rate reinforces the importance of neuromuscular training and bilateral rehab strategies. 📄 Conclusion: For young, high‑demand athletes, an all‑inside QT ACLR combined with biologic and suture tape augmentation demonstrates excellent return‑to‑activity rates and low graft failure at mid‑term follow‑up—supporting its role as a compelling option in properly selected patients. 🔗 DOI: 10.1002/ars2.70023 American Academy of Orthopaedic Surgeons (AAOS) American Orthopaedic Society for Sports Medicine Arthroscopy Journals Arthroscopy Association of North America The International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) ESSKA - European Society of Sports Traumatology, Knee Surgery & Arthroscopy Chad Lavender #SportsMedicine #Orthopedics #ACLReconstruction #QuadricepsTendon #ClinicalResearch #ACLTechniques #Arthrex #HelpingSurgeonsTreatTheirPatientsBetter

**The Future of ACL Repair: Why Restoration is Better** When an ACL injury occurs, especially a proximal tear where the ligament detaches from the femur, the traditional approach has been to remove the damaged tissue and reconstruct the ACL using grafts. While this has been the standard for decades, it comes with significant downsides. Reconstructing the ACL with "dead" tissue—tissue that no longer has its original nerve fibers, blood vessels, and cellular structure—means working with something less than ideal. But what if we could preserve and restore the native ACL, maintaining its natural components? This is not just a theoretical question; it’s a reality we can achieve today. **Why Repairing the ACL is the Superior Option** Repairing the ACL allows us to restore the ligament to its original condition, preserving its native nerve fibers, cells, and blood vessels. This approach is particularly promising in proximal tears. Instead of replacing the ACL, we repair and restore it, allowing it to heal naturally. The Bridge-Enhanced ACL Restoration (BEAR) procedure represents a significant advance in ACL repair. While not yet definitively proven, early results suggest it may reduce or prevent arthritis after an ACL injury, which is crucial to our mission to eliminate knee replacements by 2043. **A Step Toward a Knee Replacement-Free Future** Arthritis is a leading reason people need knee replacements. Repairing the ACL and reducing post-traumatic arthritis can help us achieve our goal of being knee replacement-free by 2043. This is a mission we're pursuing with every ACL repair at Victory In Motion. **Why Are We Still Using Last Century's Technology?** Despite the clear benefits, many surgeons rely on outdated techniques. ACL repair should be the first choice for eligible patients. The evidence is mounting, and the tools are available—ACL repair should be the new standard of care. **Join Us in Our Mission** At Victory In Motion, we’re leading the charge toward a future without knee replacements. Our 'Knee Repair, NOT Knee Replacement™' programs are at the forefront. If you or someone you know has been told they need ACL reconstruction, consider the benefits of repair. Let’s work together to restore your knee’s function and reduce future arthritis risk. For more information on ACL repair and how it could benefit you, visit victoryinmotion.com victorysportsmedicine.com 315-685-7544 315-707-8891 info@victorysportsmedicine.com #ACLR #ACLRepair NOT #ACLReconstruction #BEARProcedure #KneeHealth #VictoryInMotion #KneeRepairNOTKneeReplacement #Orthopedics #ArthritisPrevention #KneeReplacementFreeBy43