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Recent advances and future trends in knee arthroscopy

Knee arthroscopic surgery continues to advance in leaps and bounds. The anterior cruciate ligament (ACL) remains the most controversial structure to be operated on in the knee, and although the enthusiasm for double- bundle reconstruction has waned, there is a definite preference for anatomic reconstruction using an individualized approach. Despite early failed attempts at ACL primary repair, there is a renewed interest in this preservative approach with the application of technologically advanced instruments and implants. The thrust toward meniscal preservation too continues as better understanding of meniscal healing, improved repair techniques, and novel methods to enhance healing have encouraged surgeons to repair tears previously deemed irreparable. Similarly, articular cartilage surgery has advanced with better understanding of cellular mechanisms and the development of newer techniques of cartilage regeneration. Although the focus in the present era has been to restore anatomy with optimal biomechanical constructs, upcoming technology will address biological concerns in healing, especially with degenerate tissues. Future trends in knee arthroscopy include application of scaffolds, orthobiologics, stem cells, and bioreactors to generate personalized, and patient specific autogenous tissue engineered implants. This review article summarizes the latest developments in knee arthroscopy and predicts future trends in this rapidly advancing subspecialty.