The process of biological healing after anterior cruciate ligament (ACL) reconstruction is a possible cause for postoperative insufficiency of the graft by loosening or traumatic rerupture. The fibers of the original torn ACL should be preserved during remnant augmentation ACL reconstruction techniques. The sufficient vascularization and the many mechanoreceptors of the remnants should grow into the new autogenous tendon graft to improve healing. The remnant tissue at the insertion sites cover the bone tunnels to avoid excessive filling with synovial fluid. Besides the technique for preservation of the insertion site, there are possibilities for partial ACL bundle reconstruction as well as a refixation of the freshly ruptured ACL in combination with an augmentation using an autogenous tendon graft.
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