Kerlan Jobe Orthopaedic Clinic, Los Angeles, California, USA.
Am J Sports Med. 2018 Jul;46(9):2291-2298. doi: 10.1177/0363546517717956. Epub 2017 Aug 7.
Renewed interest has arisen in arthroscopic anterior cruciate ligament (ACL) repair techniques.
ACL repair with or without some form of internal bracing could lead to good outcomes in a carefully selected subset of patients.
Systematic review.
An electronic database search was performed to identify 89 papers describing preclinical and clinical studies on the outcome of ACL repair.
Proximal ACL tear patterns showed a better healing potential with primary repair than distal or midsubstance tears. Some form of internal bracing increased the success rate of ACL repair. Improvement in the biological characteristics of the repair was obtained by bone marrow access by drilling tunnels or microfracture. Augmentation with platelet-rich plasma was beneficial only in combination with a structural scaffold. Skeletally immature patients had the best outcomes. Acute repair offered improved outcomes with regard to load, stiffness, laxity, and rerupture.
ACL repair may be a viable option in young patients with acute, proximal ACL tears. The use of internal bracing, biological augmentation, and scaffold tissue may increase the success rate of repair.
关节镜前交叉韧带（ACL）修复技术再次引起关注。
ACL 修复术，无论是否采用某种形式的内部支撑，都可能导致精心选择的患者亚群获得良好的结果。
系统评价。
进行电子数据库搜索，以确定 89 篇描述 ACL 修复结果的临床前和临床研究论文。
与远端或中段撕裂相比，近端 ACL 撕裂模式在初次修复时具有更好的愈合潜力。某种形式的内部支撑增加了 ACL 修复的成功率。通过钻孔或微骨折来获得骨髓通道，可以改善修复的生物学特性。富含血小板的血浆的增强仅在与结构支架结合时才有益。骨骼未成熟的患者的结果最好。急性修复在负荷、刚度、松弛度和再撕裂方面提供了更好的结果。
ACL 修复术可能是急性、近端 ACL 撕裂的年轻患者的可行选择。使用内部支撑、生物增强和支架组织可能会提高修复的成功率。
