Lind Dane R G, Patil Rohan S, Amunategui Matthew A, DePhillipo Nicholas N
Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.
Ann Jt. 2023 Apr 6;8:19. doi: 10.21037/aoj-22-39. eCollection 2023.
The surgical treatment of anterior cruciate ligament (ACL) injuries dates back over 100 years from the present day [2022]. While open repair of the torn ACL was popularized in the early 1900s, the first ACL reconstructions utilized the fascia lata as a graft and other extra-articular stabilizing techniques. The first free tendon graft reported for ACL reconstructions was the quadriceps tendon (QT) in the 1930s, followed by the hamstrings tendon (HT), and then the patellar tendon. With improved understanding of the ACL anatomy and biomechanics and the invention of the arthroscope, ACL reconstruction evolved from open procedures to arthroscopic. Similarly, with the help of many surgeon-scientists who reported patient outcomes following ACL reconstruction with various techniques, graft choice evolved with the hamstrings and patellar tendon grafts becoming the dominant and preferred choice of both surgeons and patients. In present day, we see a resurgence of one of the original grafts reported, the QT, as well as primary ACL repair. Future research will result in continued advancements of ACL surgical techniques and graft harvesting, which will allow the orthopedic community (including patients and surgeons) to benefit from such innovations and advanced technologies.
前交叉韧带（ACL）损伤的外科治疗可追溯到距今100多年前（2022年）。虽然在20世纪初，撕裂的ACL开放修复术得到了推广，但首次ACL重建使用阔筋膜作为移植物以及其他关节外稳定技术。20世纪30年代报道的首例用于ACL重建的游离肌腱移植物是股四头肌肌腱（QT），随后是腘绳肌腱（HT），然后是髌腱。随着对ACL解剖结构和生物力学的理解不断加深以及关节镜的发明，ACL重建从开放手术发展到关节镜手术。同样，在许多外科医生 - 科学家报告了采用各种技术进行ACL重建后的患者预后后，移植物选择也有所发展，腘绳肌腱和髌腱移植物成为外科医生和患者的主要且首选的选择。如今，我们看到最初报道的移植物之一QT以及ACL一期修复有复兴之势。未来的研究将推动ACL手术技术和移植物获取技术的持续进步，这将使骨科界（包括患者和外科医生）从这些创新和先进技术中受益。
