BEAR ACL修复术的多种技术改良
简介
本研究介绍了桥接增强ACL修复（BEAR）技术的两种改良术式。第一种改良：将两枚行李签式缝线穿过ACL残端，连接至可调式缝线袢和纽扣组件，经股骨隧道固定残端至股骨足迹；桥接缝线穿过BEAR植入物后经胫骨隧道引出。第二种改良：同样用两枚行李签式缝线固定ACL残端，但采用无结锚钉固定至股骨足迹；桥接缝线穿过植入物后经胫骨隧道引出，再以另一枚无结锚钉固定于胫骨。两…
英文摘要
BACKGROUND: Anterior cruciate ligament (ACL) injuries are incredibly common, with an annual incidence of 68.6 per 100,000. The Bridge-Enhanced ACL Restoration (BEAR) is a relatively novel technique that combines suture repair of the ligament and a bioactive scaffold implant to bridge the gap between the torn ligament ends. Since the adoption of the BEAR technique, several modifications have been made to the original technique. These modifications are being prospectively studied within the Bridge registry. INDICATIONS: ACL tears amenable to repair. TECHNIQUE DESCRIPTION: The described technique demonstrates 2 common modifications to the original BEAR technique. The first technique passes 2 luggage tag-style sutures onto the ACL stump. These are then passed into a tensionable suture loop and button assembly. This is passed through a femoral tunnel, securing the ACL stump to the femoral footprint. Bridging sutures are attached to the button, passed through the BEAR Implant, and brought through a tibial tunnel. The second demonstrated technique again passes 2 luggage tag style sutures through the ACL stump and secures them to the femoral footprint using a knotless anchor. Bridging sutures are passed through the BEAR Implant, out a tibia tunnel, and fixed to the tibia with another knotless anchor. In both techniques, the preparation of the BEAR Implant is the same and is completed without arthroscopic visualization. RESULTS: In our experience, patients undergoing BEAR with real-world technique modifications have achieved successful outcomes. The Bridge registry has prospectively followed these patients and has published their early results. With the first 100 patients, they showed an ACL retear rate of 5% at 2 years. Furthermore, there has been a low rate of adverse events, and 61% of patients have been able to return to sport at 9 months. DISCUSSION/CONCLUSION: Several technical modifications have been developed for the use of the BEAR Implant in ACL repair. These approaches demonstrate promising early outcomes and enable surgeons to tailor the procedure according to their preferences and level of expertise. PATIENT CONSENT DISCLOSURE STATEMENT: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.