van der List Jelle P, DiFelice Gregory S
Orthopaedic Trauma Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York, U.S.A.
Arthrosc Tech. 2017 Sep 11;6(5):e1529-e1534. doi: 10.1016/j.eats.2017.06.009. eCollection 2017 Oct.
Historically, poor results of open primary repair of anterior cruciate ligament (ACL) injuries have been reported. In hindsight, however, appropriate patient selection (i.e. proximal tears and good tissue quality) was not performed, because it has recently been recognized that good outcomes of primary ACL repair are possible when selectively performed in patients with proximal tears and good tissue quality. Moreover, with modern-day advances, arthroscopic primary repair can be an excellent treatment option for patients with proximal tears. Preserving the native ACL has several advantages, including maintaining native proprioceptive function and biology. The procedure is also minimally invasive and prevents the need for formal ACL reconstruction. Recently, it has been suggested that additional suture augmentation of the primary repair technique may be beneficial for protecting ligament healing during early range of motion. In this Technical Note, we present the surgical technique of arthroscopic primary repair with suture augmentation for patients with proximal ACL tears.
历史上，曾有报道称前交叉韧带（ACL）损伤的开放一期修复效果不佳。然而，事后看来，当时并未进行合适的患者选择（即近端撕裂且组织质量良好），因为最近人们认识到，在近端撕裂且组织质量良好的患者中选择性地进行一期ACL修复，有可能获得良好的治疗效果。此外，随着现代技术的进步，关节镜下一期修复对于近端撕裂的患者而言可以是一种极佳的治疗选择。保留天然ACL有诸多优点，包括维持天然本体感觉功能和生物学特性。该手术也是微创的，并且无需进行正式的ACL重建。最近，有人提出在一期修复技术中额外使用缝线增强可能有利于在早期活动范围内保护韧带愈合。在本技术说明中，我们介绍了针对近端ACL撕裂患者采用缝线增强的关节镜下一期修复手术技术。
