The fundamental principles of the TLS concept are:

The graft

• A single tendon harvested,
• Short closed loop preparation (4 tendon strands, ST4),
• Pretensioned,
• Introduction via the arthroscopic approach (all inside),
• In press fit in the sockets,
• 100% bone contact.

Bone tunnels

• Axes of independent tunnels, obtained by aiming from outside in (out-in),
• Low caliber (4,5 mm),
• Retrograde manual digging of the bone compartments for receiving the graft,
• Sockets adapted to the diameters of the graft.

Fixing

• Suspension of the ligament loop by textile relays,
• TLS screws for tapes locking, placed from outside to inside.

The TLS system essentially addresses:

• For ACL injuries in adults, partial or complete,
• For PCL lesions.

The specific TLS instrumentation includes:

• A workstation allowing the preparation of the graft and its prestensioning (0-300N),
• A universal aiming system allowing the out-in placement of guide pins, at the tibia and femur, for the ACL and the PCL,
• A set of reamers allowing the retrograde digging of bone sockets from 6 to 11 mm.

The TLS fixation system includes:

• A TLS screw (diameter 10 mm, length 20 or 25 mm) available in titanium, peek or biocomposite.

1. Jenny, J.Y. and X. Clement, Patient-based decision for resuming activity after ACL reconstruction: a single-centre experience. Eur J Orthop Surg Traumatol, 2016. 26(8): p. 929-935.
2. Lopes, R., et al., Does retrograde tibial tunnel drilling decrease subchondral bone lesions during ACL reconstruction? A prospective trial comparing retrograde to antegrade technique. The Knee, 2016. 23(1): p. 111-115.
3. Marchand, J.B., et al., Do graft diameter or patient age influence the results of ACL reconstruction? Knee Surg Sports Traumatol Arthrosc, 2015.
4. Lefevre, N., et al., Postoperative discomfort after outpatient anterior crucial ligament reconstruction: A prospective comparative study. Orthop Traumatol Surg Res, 2015.
5. Cassard, X., et al., Anterior cruciate ligament reconstruction in children with a quadrupled semitendinosus graft: preliminary results with minimum 2 years of follow-up. J Pediatr Orthop, 2014. 34(1): p. 70-7.
6. Lefevre, N., et al., Outpatient surgery feasibility in anterior cruciate ligament reconstruction: a prospective comparative assessment. Orthop Traumatol Surg Res, 2014. 100(5): p. 521-6
7. Cazenave, M. and F. Deloge, Étude prospective sur la reprise d’activités physiques de 20 militaires après ligamentoplastie du genou par prélèvement au niveau de la patte d’oie. Kinésithérapie, la Revue, 2013. 13(137): p. 13-19.
8. Mazana, C. and P. Junk. Etude de cohorte rétrospective sur la raideur postopératoire après ligamentoplastie du LCAE. 2012; KINEANNUAIRE:[Available from: http://www.kine-annuaire.fr/sante-et-actualites/etude-de-cohorte-retrospective-sur-la-raideur-postoperatoire-apres-ligamentoplastie-du-lcae.
9. Colin, F., et al., Aseptic arthritis after ACL reconstruction by Tape Locking Screw (TLS(R)): report of two cases. Orthop Traumatol Surg Res, 2012. 98(3): p. 363-5.
10. Cassard, X., et al., Comments on: « aseptic arthritis after ACL reconstruction by Tape Locking Screw (TLS): report of two cases » by F. Colin, F. Lintz, K. Bargoin, C. Guillard, G. Venet, A. Tesson, F. Gouin published in Orthop Traumatol Surg Res 2012;98(3):363-5. Orthop Traumatol Surg Res, 2012. 98(7): p. 854; author reply 855.
11. Robert, H., R. Limozin, and T. de Polignac, Reconstruction mono-faisceau en quatre brins de semi tendinosus du ligament croisé antérieur selon la technique TLS. Résultats cliniques d’une série de 74 genoux à 18 mois de recul minimum. Revue de Chirurgie Orthopédique et Traumatologique, 2011. 97(4): p. S40-S45.
12. Collette, M. and X. Cassard, The Tape Locking Screw technique (TLS): A new ACL reconstruction method using a short hamstring graft. Orthop Traumatol Surg Res, 2011. 97(5): p. 555-9.
13. Alidrissi, N., et al., Ligamentoplastie du LCA aux ischiojambiers sous arthroscopie avec fixation de l’implant par le système TLS. Principes et résultats de 38 cas. Journal de Traumatologie du Sport, 2011. 28(3): p. 159-164.
14. Besnard, N., M. Cazenave, and J. Hryszkiewicz, La TLS, une technique novatrice de ligamentoplastie de genou au service d’une rééducation ambitieuse. Kinésithérapie Scientifique, 2010(509): p. pp. 13-20.
15. Piret, Q., Un nouveau concept de ligamentoplastie du genou : incidence sur la kinésithérapie. Kinésithérapie scientifique, 2008(488): p. 7.