Patient Stories

Stay in the Game: Collegiate Basketball Player Gets Her Jump Back with the Help of Arthrex Innovation

Maddie Niemeier’s future was looking bright. Playing basketball in Liberty, Missouri, she was an all-district player and set a school record with 15 rebounds in a game during her senior season.

After committing to continue her basketball career at Truman State University in Kirksville, Missouri, she tore her ACL during a game in January of her senior year.

“It was devastating,” she said. “I was going to have surgery right away knowing I would be able to start playing again when I got to college. But I was committed — I was going to play.”

Maddie was referred to Patrick A. Smith, MD (Columbia, Missouri), who repaired her ACL with the ACL Repair TightRope® implant and FiberRing™ sutures.

ACL repair is an innovative procedure in which a surgeon is able to repair the torn ACL by reattaching it to the bone. Instead of removing the damaged ligament and reconstructing it with a graft, ACL repair preserves the native tissue, which can lead to an easier recovery and faster return to activity[1,2]. He finished the repair with InternalBrace augmentation, which acts as a seat belt to support the repair during the healing phase.

“I always use the InternalBrace [augmentation] for the biomechanical stability it provides to the repair during the healing process,” he said. “If you can save the native ACL when it tears, you always want to. You preserve the important ACL mechanoreceptors that allow for critical neurologic feedback and more natural motion at the knee joint.”

In addition to the ACL repair, Dr. Smith performed an anteriolateral ligament (ALL) reconstruction.

“I perform an ALL reconstruction with ACL repair in all my young active patients. To me, primary ACL repair with an Internal/Brace [augmentation] and then adding the ALL procedure is the Holy Grail because it allows you to optimally control stress on the repair itself. And for Maddie, for her repair to work and to be able to withstand the stress of playing college basketball, she needed that additional protection,” Dr. Smith said.

Maddie has now returned to playing with a knee that she says feels “100 percent.”

 “When I got back on the court, I was initially scared, but that was mental. Once I knew I could trust my knee, I jumped right back in. I have complete confidence,” she said.



  1. Vermeijden HD, van der List JP, O'Brien R, DiFelice GS. Return to sports following arthroscopic primary repair of the anterior cruciate ligament in the adult population. Knee. 2020;27(3):906-914. doi:10.1016/j.knee.2020.04.001

  2. Mayo Clinic. ACL injury: diagnosis & treatment. Diseases & Conditions. Accessed April 5, 2024.


The InternalBrace™ surgical technique is intended only to augment the primary repair/reconstruction by expanding the area of tissue approximation during the healing period and is not intended as a replacement for the native ligament. The InternalBrace™ technique is for use during soft tissue-to-bone fixation procedures and is not cleared for bone-to-bone fixation.
This is not medical advice and is not meant to be a substitute for the advice provided by a surgeon or other qualified medical professional on the use of these products. You should talk with your physician or health care provider for more information about your health condition and whether Arthrex products might be appropriate for you. The surgeon who performs any surgical procedure is responsible for determining and using the appropriate techniques for surgical procedures on each individual patient. Arthrex recommends that surgeons be trained on the use of any particular product before using it in surgery. A surgeon must always rely on their own professional medical judgment when deciding whether to use a particular product when treating a particular patient. A surgeon must always refer to the package insert, product label, and/or directions for use before using any Arthrex product. Postoperative management is patient-specific and dependent on the treating professional’s assessment. Individual results will vary and not all patients will experience the same postoperative activity level or outcomes. Products may not be available in all markets because product availability is subject to the regulatory approvals and medical practices in individual markets. Please contact Arthrex if you have questions about the availability of products in your area.
This real patient was compensated for the time she took to share her personal experience with her ACL repair.
Physician is a paid consultant of Arthrex, Inc.