改良解剖学全内双束前交叉韧带重建技术
简介
该研究描述了一种改良的全内双束ACL重建技术，采用4个骨道与皮质悬吊固定，结合束别独立张紧，旨在保留骨量并优化移植物利用。与传统双束技术相比，该术式可能减少骨道扩大和融合风险，同时更接近原生ACL解剖结构。目前尚缺乏高质量临床证据对比，但为高需求患者（如运动员）提供了兼顾稳定性和骨量保留的技术选项。
英文摘要
Arthroscopic anterior cruciate ligament (ACL) reconstruction (ACLR) is the standard surgical treatment for ACL injuries and is most commonly performed using anatomical single-bundle (SB) or double-bundle (DB) techniques. With the development of the all-inside technique, the all-inside SB technique using socket-based tunnels and cortical suspensory fixation has gained popularity because it helps preserve bone stock, reduces postoperative pain, and provides reliable knee stability. Compared with the SB technique, the DB technique achieves comparable clinical outcomes, more closely replicates native ACL anatomy, and may provide superior anterior and rotational stability, lower revision rates, and higher return-to-sport rates in athletes and other high-demand patients. However, the conventional DB technique requires substantial bone removal, is prone to tunnel widening or coalescence, and uses graft tissue less efficiently. To address these limitations, we describe a modified anatomical all-inside DB technique that combines the advantages of the all-inside technique and DB technique. This technique employs 4 bone sockets with suspensory fixation and bundle-specific tensioning to preserve bone stock, optimize graft utilization, and facilitate anatomic DB reconstruction.