Primary repair of the anterior cruciate ligament: real innovation or reinvention of the wheel?

Excerpt

It is a frequently encountered fact that if one waits long enough in orthopaedic surgery, procedures that have fallen out of favour in the past become popular again. One can find numerous recent examples which have experienced a resurgence despite historically unsatisfying results. Typically, reintroduction of a previously used procedure is based upon theoretical improvements due to modern advances and is accompanied by a tremendous marketing effort that highlights the potential benefits of the procedure. The orthopaedic surgeon has to make a well-balanced decision and weight the risk against the possible benefits of performing such a procedure. When a surgeon decides to take the often at this stage unknown risk, he would face the threat of being defined as an early adopter. Early adopters place more emphasis on the benefits of these innovations than on their risks [10]. They offer innovations at an early stage to their patients, although there is usually limited clinical data available. However, in an evidence-based orthopaedic world, it is important to analyze the outcome of every procedure in high-quality clinical studies. It is our responsibility as orthopaedic surgeons to learn from historical experience and not to repeat the mistakes of the past. …