摘要
前十字韧带(anterior cruciate ligament, ACL)损伤是膝关节最常见的运动性损伤之一, 可导致运动功能受限和膝关节退行性变, 严重影响患者的生活质量。关节镜下ACL重建已成为治疗ACL损伤的金标准。为进一步提升ACL重建手术的精准化与微创化, 进而实现快速康复, 全内重建技术受到越来越多的关注, 经过近30年发展该技术不断趋于成熟。与传统重建技术相比, 全内技术在临床疗效上并无明显差异。全内技术的主要优势在于节省肌腱、保留更多骨量、减轻术后疼痛、防止关节液渗漏、增加腱-骨愈合面积、避免挤压螺钉相关并发症以及适用于骨骼未成熟的儿童及青少年。然而, 由于全内技术为新兴技术, 学习曲线和手术时间较长, 手术费用较传统重建高, 骨隧道制作与移植物固定不当还可能导致术后骨隧道增宽, 从而影响手术疗效。通过对全内技术的发展与演变历史、临床疗效、优缺点等方面进行综述, 为全内技术重建ACL提供理论依据与帮助。
Rupture of anterior cruciate ligament(ACL)is one of the most common sports injuries of the knee,which may cause limitation of motor function and degeneration of the knee,seriously affecting patients'living quality.Currently,arthroscopic ACL reconstruction(ACLR)has been identified as the gold standard for ACL rupture.In an effort to further increase surgical accuracy and decrease surgical trauma so as to promotes quick recovery,all-inside ACLR has gained increasing attention in recent years.All-inside ACLR is as effective as traditional reconstruction,but it has benefits such as the preservation of tendons,preservation of bone mass,reduction of postoperative pain,prevention of synovial fluid leakage,expansion of the tendon-bone healing area,avoidance of complications related to extrusion screws,and suitability for children and adolescents.However,applying of numerous novel techniques for all-inside ACLR increases the learning curve,operating time,and cost.Besides,improper bone tunnel fabrication and graft fixation may lead to the widening of the bone tunnel,affecting the surgical effect.Therefore,in order to provide a theoretical foundation for further promoting the clinical application of this technique,this article reviews the development,evolution,and clinical outcomes of this technique as well as its advantages and disadvantages.
作者
冯建豪
徐一宏
徐卫东
Feng Jianhao;Xu Yihong;Xu Weidong(Department of Orthopaedics,Tongji Hospital,Tongji University,Shanghai,200065,China;Department of Joint Surgery,the First Affiliated Hospital of Naval Medical University(Shanghai Changhai Hospital))
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2023年第8期526-533,共8页
Chinese Journal of Orthopaedics
基金
2020年上海市体育科技"备战攻关"项目(20J017)。
关键词
膝关节
前交叉韧带重建
关节镜检查
综述
Knee joint
Anterior cruciate ligament reconstruction
Arthroscopy
Review
