Editorial Commentary: Anterior Cruciate Ligament Primary Repair Has Limited Indications and Outcomes Inferior to Anterior Cruciate Ligament Reconstruction

The anterior cruciate ligament (ACL) primary repair literature does not convincingly show noninferiority to the gold standard of ACL reconstruction using a graft. Primary repair has narrow indications, typically a Sherman type 1 tear pattern representing a femoral avulsion with good tissue quality. In addition, recent research has shown greater postoperative laxity in repairs deemed successful in comparison to laxity in patients undergoing reconstruction. Our primary point is worth repeating: In contrast to ACL primary repair, ACL reconstruction is the gold standard for ACL tears.