Primary repair of the anterior cruciate ligament.

The anterior cruciate ligament (ACL) is the primary restraint preventing anterior tibial translation on the femur. Its absence is highly correlated with the presence of a pivot shift sign and clinical instability. Primary ACL repair, at times with augmentation, is advocated in those patients most apt to develop symptomatic instability. Follow-up studies demonstrate that it is possible to prevent the development of symptomatic giving way as well as the meniscal degeneration frequent in active patients with chronic ACL insufficiency.