ACL and Rotator Cuff Surgical Techniques
ACL Reconstruction & Repair
At Academy Orthopedics, our sports medicine surgeons utilize the latest techniques and evidence-based approaches to treat ACL injuries. Because every ACL injury and every patient is different, treatment is individualized based on factors such as age, activity level, athletic goals, anatomy, injury pattern, and tissue quality.
Depending on the patient and the specific injury, surgical options may include ACL reconstruction with an autograft using bone–patellar tendon–bone (BTB) or quadriceps tendon, allograft reconstruction, or ACL repair when the injury pattern and tissue quality make repair appropriate. Our surgeons are experienced with these techniques and select the approach that best fits each patient’s individual needs and goals.
The videos below demonstrate ACL surgical techniques utilizing Arthrex autograft BTB and quadriceps tendon grafts.
BTB Autograft
A bone–patellar tendon–bone (BTB) autograft uses the central portion of the patellar tendon along with small bone plugs from the patella and tibia. The bone plugs allow the graft to be securely fixed within bone tunnels and provide reliable bone-to-bone healing. BTB autografts have a long history of successful use in ACL reconstruction, particularly in young and athletic patients.
Quadriceps Tendon Autograft Video
A quadriceps tendon autograft uses a portion of the quadriceps tendon above the kneecap. It provides a strong, robust graft while avoiding harvest from the hamstring or central portion of the patellar tendon. Depending on the surgical technique, the graft may be harvested with or without a bone plug.
The choice of graft and surgical technique is carefully discussed with each patient to determine the approach most appropriate for their injury, lifestyle, and goals.
Lateral Extra-Articular Tenodesis (LET)
At Academy Orthopedics, our sports medicine surgeons may recommend a lateral extra-articular tenodesis (LET) as an additional procedure during ACL reconstruction for select patients. LET is designed to improve rotational stability of the knee and may help reduce the risk of recurrent ACL injury in patients at higher risk of reinjury.
During the procedure, a strip of the iliotibial (IT) band on the outer side of the knee is used to reinforce the lateral aspect of the knee. The tissue is routed and secured to help control excessive rotational movement, working alongside the reconstructed ACL to provide additional stability.
LET may be considered for patients with increased risk factors for ACL reinjury, including young athletes returning to high-demand pivoting sports, significant rotational instability, or revision ACL reconstruction. The decision to perform LET is individualized based on the patient’s injury pattern, anatomy, activity level, and athletic goals.
Scientific Evidence Behind LET
Learn more about the scientific research and clinical evidence supporting the use of lateral extra-articular tenodesis (LET) in combination with ACL reconstruction.
Lateral Extra-Articular Tenodesis (LET) Procedure Video
The video below demonstrates the LET surgical technique and how this procedure can be used in conjunction with ACL reconstruction to help improve knee stability.
Anterolateral Ligament (ALL) Reconstruction
At Academy Orthopedics, our sports medicine surgeons may consider anterolateral ligament (ALL) reconstruction as an additional procedure in select patients undergoing ACL reconstruction. The ALL is a structure located along the outer side of the knee that contributes to rotational stability and helps control excessive internal rotation of the tibia.
During ALL reconstruction, a tendon graft is used to recreate the function of the anterolateral ligament. The graft is positioned and secured along the outer aspect of the knee to help improve rotational control and work alongside the reconstructed ACL to restore knee stability.
Our surgeons carefully evaluate each patient to determine whether ALL reconstruction may provide additional benefits as part of their overall treatment plan.
Anterolateral Ligament (ALL) Reconstruction Procedure Video
The video below demonstrates the ALL reconstruction technique and how this procedure may be performed in conjunction with ACL reconstruction to help improve rotational stability of the knee.
Rotator Cuff Tear Repair & Superior Capsular Reconstruction
At Academy Orthopedics, our sports medicine surgeons utilize advanced, evidence-based techniques to treat rotator cuff injuries and restore shoulder function. Treatment is individualized based on the size and pattern of the tear, tissue quality, patient activity level, and overall shoulder health.
When possible, rotator cuff tears are repaired arthroscopically with the goal of restoring the tendon’s natural attachment to the bone and improving pain, strength, and function.
For patients with chronic, long-standing, or irreparable rotator cuff tears that cannot be repaired directly, particularly those with minimal or limited shoulder arthritis, our surgeons may consider a Superior Capsular Reconstruction (SCR). This advanced procedure uses a graft to reconstruct the superior capsule of the shoulder, helping restore stability, improve shoulder biomechanics,and decrease pain when the rotator cuff is no longer functional.
The videos below demonstrate advanced arthroscopic techniques used in rotator cuff treatment, including Arthrex SpeedBridge™ rotator cuff repair and Arthrex Superior Capsular Reconstruction.
Arthrex SpeedBridge™ Rotator Cuff Repair
This video demonstrates the Arthrex SpeedBridge™ technique. It is an advanced arthroscopic, knotless rotator cuff repair construct designed to provide broad tendon-to-bone compression and secure fixation. The technique uses medial and lateral row anchors to create a suture-bridge construct, helping restore the tendon footprint on the greater tuberosity while providing a stable repair.
Arthrex Superior Capsular Reconstruction (SCR)
This video demonstrates the Arthrex Superior Capsular Reconstruction (SCR) technique. This is an arthroscopic procedure used for selected patients with irreparable rotator cuff tears. A graft is secured between the glenoid and greater tuberosity to reconstruct the superior capsule, helping restore shoulder stability, improve biomechanics, decrease pain, and maintain the functional position of the humeral head.
Arthroscopic Trapezius Transfer for Rotator Cuff Deficiency
At Academy Orthopedics, our sports medicine surgeons may consider a lower trapezius tendon transfer for select patients with severe, irreparable rotator cuff tears, particularly those involving the posterosuperior rotator cuff that result in weakness and loss of shoulder function.
During the procedure, the lower trapezius tendon is transferred to the upper arm, typically using a tendon graft to bridge the distance between the tendon and its new attachment site on the humerus. The transferred tendon helps restore external rotation and improve shoulder mechanics by providing an alternative source of muscle function when the native rotator cuff is no longer functional.
Treatment recommendations are individualized based on the patient’s tendon deficiency, remaining shoulder function, tissue quality, activity level, and overall goals.
Arthroscopic Lower Trapezius Tendon Transfer Procedure Video
The video below demonstrates the lower trapezius tendon transfer technique.