Repair of the anterior cruciate ligament (ACL) can be accomplished in selected tears where the ligament tissue is in good condition and the tear is close to the bone. It is best if the patient is over 35 years old.

	ACL repair is possible if the ACL is of good quality and if the ligament can be passed posterior to the PCL, both of which are determined in surgery. Acutely (recently) torn ligaments are typically of better quality and therefore, have a greater chance of being repaired as opposed to the chronically torn ligaments.
	Once the ligament is deemed repairable, sutures are passed through the proximal aspect of the ligament. A posterior intercondylar notchplasty is performed between the two femoral condyles of the thigh bone.
	The area is then microfractured with a series of small punctures deep into the posterior notch to create a bleeding bed.
	The anatomic insertion site in this notch where the ACL tore from is identified and a hole is placed.
	A suture anchor is then loaded into the sutures, passed into the hole, and the sutures are tied with a fisherman's slip knot.
	Now the surgeon can pull or secure the ACL back into the anatomic insertion site.
	An autogenous blood clot (formed with the patient's own blood) is harvested during surgery and mixed into a fibrous clot. It is packed into the proximal site to improve the healing bed. Sutures are tied over the fibrous clot to hold it into place.