[1]黄兆进杨明方潇翔唐科兴欧阳攀李良军**.关节镜下全内技术与单纯可吸收挤压螺钉固定技术单束重建成人前交叉韧带的中长期临床疗效比较[J].中国微创外科杂志,2026,01(3):0.
　Huang Zhaojin,Yang Ming,Fang Xiaoxiang,et al.Comparison of Midtolongterm Clinical Outcomes Between Arthroscopic Allinside Technique and Simple Bioabsorbable Interference Screw Fixation for Singlebundle Reconstruction of the Anterior Cruciate Ligament in Adults[J].Chinese Journal of Minimally Invasive Surgery,2026,01(3):0.
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关节镜下全内技术与单纯可吸收挤压螺钉固定技术单束重建成人前交叉韧带的中长期临床疗效比较()

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2026年3期
页码:
0
栏目:
临床论著
出版日期:
2026-03-26

文章信息/Info

Title:
Comparison of Midtolongterm Clinical Outcomes Between Arthroscopic Allinside Technique and Simple Bioabsorbable Interference Screw Fixation for Singlebundle Reconstruction of the Anterior Cruciate Ligament in Adults
作者:
黄兆进杨明方潇翔唐科兴欧阳攀李良军**
(南华大学衡阳医学院附属长沙中心医院运动医学科，长沙410000)
Author(s):
Huang Zhaojin;  Yang Ming;  Fang Xiaoxiang;  et al.
Department of Sports Medicine, Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha 410000, China
关键词:
前交叉韧带; 前交叉韧带重建; 全内技术; 传统技术
Keywords:
Anterior cruciate ligament; Anterior cruciate ligament reconstruction; Allinside technique; Conventional technique
文献标志码:
A
摘要:
目的比较全内与单纯可吸收挤压螺钉固定技术单束重建成人前交叉韧带(anterior cruciate ligament, ACL)术后中长期的临床疗效。方法回顾性分析2018年1月～2019年12月我科62例因单纯ACL完全断裂行ACL单束重建手术的临床资料。根据ACL重建手术方式的不同，将患者分为全内组(n=30)和传统组(n=32)。比较2组围手术期资料，术前、术后1个月、术后3个月及末次随访国际膝关节文献委员会(International Knee Documentation Committee，IKDC)评分、Lysholm评分及Tegner评分，并使用Tegner评分预估患者重返运动率及重返受伤前运动水平率。术后36个月采用前抽屉试验、Lachman试验、轴移试验评估膝关节稳定性。结果2组术中出血量、住院时间差异无显著性(P＞0.05)；全内组比传统组手术时间更长、移植物直径更大［(91.6±20.4)min vs.(75.3±22.3)min，t=2.053，P=0.004；(8.5±0.6)mm vs.(7.3±05)mm, t=8.945，P=0.000］。2组随访时间均＞36个月，全内组随访(56.6±5.5)月，其中＞60个月占40.0%(12/30)；传统组随访(58.8±4.7)月，其中＞60个月占46.9%(15/32)。2组中长期随访IKDC评分、Lysholm评分、Tegner评分差异无显著性(P>0.05)。全内组较传统组Lachman试验、前抽屉试验等级下降明显(Z=-3.133，P=0.002；Z=-2.664，P=0008)，轴移试验差异无显著性(P=0.912)。术后36个月全内组重返运动率显著高于传统组［80.0%(24/30)vs. 56.2%(18/32), χ2=3.997,P=0.046］，2组重返受伤前运动水平率差异无显著性(P=0.323)。结论全内技术与传统技术单束重建ACL术后均可取得良好的临床疗效，相比于传统技术，全内技术取腱数量更少，术后中长期膝关节前后向稳定性更优、重返运动率更高，但全内组手术耗时更长。
Abstract:
ObjectiveTo compare the midtolongterm clinical outcomes between the allinside technique and simple bioabsorbable interference screw fixation for singlebundle reconstruction of the anterior cruciate ligament (ACL) in adults.MethodsA retrospective analysis was conducted on 62 patients who underwent singlebundle ACL reconstruction for complete isolated ACL tears between January 2018 and December 2019. The patients were categorized into an allinside group (n=30) and a conventional group (n=32) based on surgical technique. Systematic comparison was performed between the two groups regarding perioperative data, as well as International Knee Documentation Committee (IKDC) scores, Lysholm scores, and Tegner scores assessed preoperatively, and at postoperative 1 month, 3 months, and final followup. The Tegner scores were used to estimate returntosports rates and preinjury activity level recovery. Knee stability was assessed at postoperative 36 month using anterior drawer, Lachman, and pivot shift tests.ResultsNo significant differences were observed in intraoperative blood loss or hospitalization length between the two groups (P>005). The allinside group exhibited longer operative times and larger graft diameters compared to the conventional group ［(91.6±20.4) min vs. (75.3±22.3) min, t=2.053, P=0.004; (8.5±0.6) mm vs. (7.3±0.5) mm, t=8.945, P=0.000］. Both groups had followup periods exceeding 36 months. The allinside group was followed up for (56.6±5.5) months, with 40.0% (12/30) exceeding 60 months. The conventional group was followed up for (58.8±4.7) months, with 46.9%(15/32) exceeding 60 months. The IKDC, Lysholm, and Tegner scores showed no significant intergroup differences at midtolongterm followup (P>005). The allinside group achieved significantly better grades on Lachman (Z=-3.133, P=0.002) and anterior drawer tests (Z=-2.664, P=0.008), while no significant difference in pivot shift tests (P=0.912). At the postoperative 36 month followup, the allinside group demonstrated a significantly higher returntosports rate compared to the conventional group ［80.0%(24/30) vs. 56.2%(18/32), χ2=3.997, P=0.046］, while no significant difference was observed in the rate of return to preinjury sports activity levels between the two groups (P=0.323).ConclusionsBoth allinside and conventional singlebundle ACL reconstruction yield favorable clinical outcomes. Compared to conventional technique, the allinside approach requires fewer tendon harvests, achieves better midtolongterm anteroposterior knee stability, and results in higher returntosports rates, albeit with longer operative time.

参考文献/References:

[1]Webster KE,Hewett TE.Anterior cruciate ligament injury and knee osteoarthritis:an umbrella systematic review and metaanalysis.Clin J Sport Med,2022,32(2):145-152.
[2]Yang YT,Cai ZJ,He M,et al.Allinside anterior cruciate ligament reconstruction:a review of advance and trends.Front Biosci Landmark,2022,27(3):91.
[3]印钰,梅宇,王泽刚,等.股骨骨道过短的膝关节镜下前交叉韧带重建术中固定襻与可调襻应用的比较研究.中国微创外科杂志,2024,24(12):785-790.
[4]康宇翔,赵谦,任志鹏.全内技术与传统技术重建前交叉韧带的临床疗效对比研究.中华骨与关节外科杂志,2019,12(4):281-284.
[5]Zhu S,Li R.Allinside anterior cruciate ligament reconstruction had clinical outcome similar to the transtibial technique except for improved sidetoside difference and tegner activity scale:a systematic review and metaanalysis.Arthrosc J Arthrosc Relat Surg,2024,40(8):2276-2288.
[6]王凡,王国梁,李彦林,等.I.D.E.A.L技术与经胫骨隧道技术重建前交叉韧带的疗效比较研究.中国修复重建外科杂志,2024,38(8):987-994.
[7]Briggs KK,Lysholm J,Tegner Y,et al.The reliability,validity,and responsiveness of the Lysholm score and Tegner activity scale for anterior cruciate ligament injuries of the knee:25 years later.Am J Sports Med,2009,37(5):890-897.
[8]Huang H,Zhang D,Jiang Y,et al.Translation,validation and crosscultural adaptation of a simplifiedChinese version of the Tegner activity score in Chinese patients with anterior cruciate ligament injury.PLoS ONE,2016,11(5):e0155463.
[9]Klasan A,Putnis SE,Grasso S,et al.Tegner level is predictive for successful return to sport 2 years after anterior cruciate ligament reconstruction.Knee Surg Sports Traumatol Arthrosc,2021,29(9):3010-3016.
[10]施政良,李彦林,余洋,等.前交叉韧带重建术后重返运动评估方法研究进展.中国修复重建外科杂志,2023,37(4):495-501.
[11]Goyal T,Das L,Paul S,et al.Outcomes of retrodrilled allinside tibial tunnel vs complete tibial tunnel techniques in anterior cruciate ligament reconstruction:a comparative study.Eur J Orthop Surg Traumatol,2022,32(3):523-532.
[12]罗学辉,杜绍龙.前交叉韧带重建中移植物直径大小与膝关节功能的关系.中国组织工程研究,2022,26(34):5482-5485.
[13]Eichinger M,Ploner M,Degenhart G,et al.Tunnel widening after ACL reconstruction with different fixation techniques:aperture fixation with biodegradable interference screws versus allinside technique with suspensory cortical buttons.5year data from a prospective randomized trial.Arch Orthop Trauma Surg,2023,143(11):6707-6718.
[14]Devitt BM,Maes M,Feller JA,et al.No longterm tunnel enlargement following anterior cruciate ligament reconstruction using autograft hamstring tendon with dual suspensory fixation.Knee Surg Sports Traumatol Arthrosc,2020,28(7):2157-2162.
[15]Mayr R,Smekal V,Koidl C,et al.ACL reconstruction with adjustablelength loop cortical button fixation results in less tibial tunnel widening compared with interference screw fixation.Knee Surg Sports Traumatol Arthrosc,2020,28(4):1036-1044.
[16]Fu CW,Chen WC,Lu YC.Is allinside with suspensory cortical button fixation a superior technique for anterior cruciate ligament reconstruction surgery?A systematic review and metaanalysis.BMC Musculoskelet Disord,2020,21(1):445.
[17]Lv X,Wang M,Zhao T,et al.Allinside versus complete tibial tunnel techniques in anterior cruciate ligament reconstruction:a systematic review and metaanalysis of randomized controlled trials.J Orthop Surg,2023,18(1):127.
[18]Browning WM,Kluczynski MA,Curatolo C,et al.Suspensory versus aperture fixation of a quadrupled hamstring tendon autograft in anterior cruciate ligament reconstruction:a metaanalysis.Am J Sports Med,2017,45(10):2418-2427.
[19]Garcés GL,Martel O,Yánez A,et al.In vitro testing of 2 adjustableloop cortical suspensory fixation systems versus interference screw for anterior cruciate ligament reconstruction.Orthop J Sports Med,2021,9(9):23259671211031652.
[20]Xu J,Jia Y,Zhang B,et al.Comparison of the clinical outcomes between allinside and standard technique in anterior cruciate ligament reconstruction with 6strand hamstring tendon autograft.Orthop Surg,2024,16(5):1034-1041.
[21]Kulshrestha V,Sood M,Kumar S,et al.Original study:early patientreported functional outcome of allinside ACL reconstruction as compared to anteromedial portal technique.Eur J Orthop Surg Traumatol Orthop Traumatol,2021,31(7):1477-1483.
[22]Sandon A,Engstrm B,Forssblad M.High risk of further anterior cruciate ligament injury in a 10year followup study of anterior cruciate ligamentreconstructed soccer players in the swedish national knee ligament registry.Arthrosc J Arthrosc Relat Surg,2020,36(1):189-195.
[23]Meierbachtol A,Obermeier M,Yungtum W,et al.Injuryrelated fears during the returntosport phase of acl reconstruction rehabilitation.Orthop J Sports Med,2020,8(3):2325967120909385.
[24]Mir B,Vivekanantha P,Dhillon S,et al.Fear of reinjury following primary anterior cruciate ligament reconstruction:a systematic review.Knee Surg Sports Traumatol Arthrosc,2023,31(6):2299-2314.
[25]安思兰,郑群怡,任牧晨.前交叉韧带重建术后患者恐动症的研究进展.中华骨与关节外科杂志,2024,17(1):90-96.
[26]Prentice H,Chan P,Paxton E,et al.Patient and operative risk factors for osteoarthritis after primary anterior cruciate ligament reconstruction: a cohort study of 41,976 patients.Am J Sports Med,2024,52(10):2482-2492.
[27]Wang L,Zeng N,Yan Z,et al.Posttraumatic osteoarthritis following ACL injury.Arthritis Res Ther,2020,22(1):57.
[28]Webster K,Hewett T.Anterior cruciate ligament injury and knee osteoarthritis:an umbrella systematic review and metaanalysis.Clin J Sport Med,2022,32(2):145-152.

备注/Memo

备注/Memo:
基金项目：湖南省自然科学基金项目(2025JJ80584)；长沙市自然科学基金项目(kq2403166)；长沙市卫生健康委中医药科研计划项目(SB2024-046)**通讯作者，Email：liliangjun1212@sina.com
更新日期/Last Update: 2026-03-26