TLS Short Graft ACL Reconstruction – Concepts and Early Surgical Results

Dr Robert Gordon, clinical and research Fellow to Dr Kelly Macgroarty, recently delivered a presentation at the 2017 Combined Orthopaedic Knee Society meeting, held at Noosa Heads, on “TLS Short Graft ACL Reconstruction – Concepts and Early Surgical Results”. 

The short graft ACL reconstruction technique used by Dr Macgroarty has been developed over the last 10 years in Europe.  There have been more than 40,000 operations of its kind across the globe. Dr Macgroarty was one of the first people in Australia to adopt this innovative technique for anterior cruciate ligament (ACL) reconstructions.

In traditional ACL reconstructions, two Hamstring tendons are harvested and used to create a long, slim graft that is secured in place in large bone tunnels, by either a direct screw into the graft or by a suspension device that sits on the outside of the bone. The graft diameter obtained is often less than 8mm and the types of fixation have a similar strength to the forces that go through the ACL in normal walking.

With the short graft Tape Locking Screw (TLS®) technique, only 1 Hamstring is taken (in 90% of cases) and wrapped 4 times to create a shorter, much larger diameter graft averaging 9mm. It is then fixed in place inside the bone with a screw-tape interface which is 3 times stronger than the traditional fixation.

The larger graft diameter has been shown in studies to reduce the chance of re-rupturing the graft in the future and the superior graft fixation allows for early walking and strengthening to begin, which in turn has a multitude of benefits.

There are major benefits for the patient from sparing a hamstring, including decreased donor site morbidity, improved speed of return of hamstring strength, preservation of future graft source and much greater potential for improved rotational stability.

Furthermore, the larger graft size reduces the chance of re-injury, and stronger fixation allows for earlier rehabilitation and return to walking. 

Overall, the TLS® system represents a safe and effective technique for ACL reconstruction.  It is a less traumatic surgical technique leading to less bony bruising and therefore less pain. This means an earlier return to work and or sports training for the patient.





American Academy of Orthpaedic Surgeons Australian Orthopaedic Association   Royal Australian College of Surgeons    International Society of Arthoscopy, Knee Surgery & Orthpaedic Sports Medicine     Queensland Shoulder Society

 Australian Knee Society  Shoulder & elbow society of Australia  Australian_Medical_Association    SPORTS MEDICINE AUSTRALIA    american board of independent medical examiners