前交叉韧带重建中全内技术与完全胫骨隧道技术采用腘绳肌腱自体移植物的临床与影像学结果：一项前瞻性比较研究
简介
一项前瞻性对照研究纳入60例ACL重建患者，比较全内技术与完整胫骨隧道技术（均采用腘绳肌腱自体移植物）的临床与影像学结果。随访18–24个月显示，两组功能评分、稳定性及MRI参数（移植物完整性、松弛度、PCL buckling）无显著差异，但全内技术组胫骨隧道扩大显著更小。提示全内技术通过闭合骨道及悬吊固定减少胫骨骨量丢失，影像学占优且不牺牲临床疗效。
英文摘要
INTRODUCTION: Anterior cruciate ligament (ACL) reconstruction aims to restore knee stability and function while minimizing tunnel-related complications. The all-inside technique was developed to preserve bone stock, reduce post-operative pain, and improved function. This study, therefore, aimed to compare clinical and radiological outcomes between the all-inside and full tibial tunnel ACL reconstruction techniques. MATERIALS AND METHODS: The study prospectively enrolled 60 patients and divided in two groups, 30 patients in each, an all-inside and full tibial tunnel group. At final follow-up, subjective functional scores were used to assess the functional outcome, and magnetic resonance imaging (MRI) was used to assess socket/tunnel widening and graft characteristics. Subjective functional scores included the Lysholm knee score, the International Knee Documentation Committee score, and the knee society score for pain and function. MRI was used to measure the value of bone socket/tunnel widening, graft fiber integrity, graft laxity, and posterior cruciate ligament (PCL) buckling. RESULTS: At the final follow-up of 18-24 months, no significant differences were found with respect to femoral socket widening and subjective function scores. However, a significant increase in tibial tunnel diameter was found in the full tibial tunnel group compared to the all-inside group (P < 0.005). Knee stability and MRI parameters, including graft continuity, graft laxity, and PCL buckling, were comparable between groups. CONCLUSION: Both surgical techniques result in satisfactory clinical and radiological outcomes following ACL reconstruction. However, the all-inside technique offers a radiological advantage by significantly reducing tibial tunnel enlargement, likely due to closed socket creation and suspensory fixation, making it a biomechanically favorable option without compromising functional results.