Beginning in 2001 and with worldwide usage since 2007, the CoLS knee ligament repair system has been performed successfully over 43,000 times, including more than 2000 procedures in the United States.

The CoLS system was designed to increase the strength and rigidity of soft-tissue ACL repairs while allowing the patient to experience minimal discomfort. Using only the semitendinosus tendon, the CoLS system is both tissue-sparing and bone-sparing, and allows for the creation of an almost entirely anatomic ACL repair.

With its press fit aperture fixation and an inelastic, back up tape fixation, the CoLS has been proven to heal stronger and better than any other ACL fixation currently available. It also allows the patient to return to activities of daily life almost immediately, with little to no musculature degradation.??The CoLS features a short, quadruple bundled soft-tissue graft which is pretensioned to remove almost all laxity from the graft. This not only makes the graft function better post operatively, but it removes most post operative laxity from the graft, ensuring stability of the knee for years to come.



Resulting from a long surgical experience, The CoLS system principles were first described in 2001 by a Belgian orthopedic surgeon, Dr Michel Collette, who has been continuously trying hard to improve the mechanical properties of ACL reconstruction techniques, while reducing at the most the unwanted traumatic effects bound to these techniques.

Based on these principles, the surgical technique, such as it exists today, was then developed since 2003 in collaboration with Dr Xavier Cassard, from Toulouse, France.
The CoLS system is a revolutionary concept in the use of soft tissue knee ligament repair that aims to counter the main complaints that continue to arise from other methods of soft tissue repairs.
Using only the semitendinosus tendon, the quadrupled graft is recognized as the strongest construct possible. Suspended by inelastic tapes which are packed into the bone by blunt interference screws, the graft is sized and press fit into sockets that are retro-reamed by hand. These sockets are made to match the individual size of each end of the graft, ensuring that there is no wasted tendon in the joint space or sockets themselves.

The procedure is performed using outside-in femoral targeting, with the tibial tunnel drilled independently, which allows for improved coronal plane positioning. With this improved positioning, the graft can be positioned perfectly in the anatomic footprint of the native ACL/PCL, giving the patient better functionality of the repaired ligament.

The sockets, which are retroreamed atraumatically to 10mm on the femur and 15mm on the tibia, are diametrically precise for each end of the individual graft rather than using a “one-size-fits-all” technique. The only damage to the graft is suturing and tensioning, with the fixation screw never needing to come in contact with the graft. This leads to stronger and greater healing of the graft/bone interface which is critical to overall patient healing and recovery.

The CoLS system has been time-tested as an emerging gold standard in ligament repair due to short, precise tunnels, a graft that is pretensioned to remove future laxity, and fixation designed to promote healing.