Russo Arcangelo, Costa Giuseppe Gianluca, Musumeci Maria Agata, Giancani Michele, Di Naro Calogero, Pegreffi Francesco, Testa Gianluca, Sapienza Marco, Pavone Vito
Faculty of Medicine and Surgery, Kore University of Enna, 94100 Enna, Italy.
Orthopaedic and Traumatologic Unit, Umberto I Hospital, Azienda Sanitaria Provinciale di Enna, 94100 Enna, Italy.
Healthcare (Basel). 2025 May 4;13(9):1056. doi: 10.3390/healthcare13091056.
Anterior cruciate ligament (ACL) injuries are common among athletes and significantly impact their knee stability and performance. Surgical reconstruction is the standard treatment. The modified transtibial technique has emerged as a promising surgical approach for optimal graft positioning and complication reduction.
A retrospective study of athletes who underwent primary ACL reconstruction with the modified transtibial technique was conducted. Clinical outcomes were evaluated using the Lysholm and International Knee Documentation Committee (IKDC) subjective scores and objective knee stability assessments. Return-to-sport rates and associated factors were analyzed.
Forty-four athletes were included (thirty-seven males, seven females; mean age 21.2 ± 5.0 years). At mean follow-up of 27.0 ± 12.2 months, significant improvements in the Lysholm and IKDC subjective scores were observed. Overall, 88.2% of athletes returned to sports, and 65.9% achieved their pre-injury levels. Return to pre-injury level was defined as regaining the same type, intensity, and frequency of sport participation as before the injury occurred. Professional athletes showed significantly higher return-to-pre-injury-sport rates (79.3%) than recreational athletes (40.0%, = 0.0091). Concomitant meniscus injuries negatively impacted return-to-sport rates (92.9% versus 66.7%, = 0.0397). The overall failure rate was 4.6% (2/44; 95% confidence level [CI]: 0.6-15.5%) with two cases of graft insufficiency or re-rupture.
ACL reconstruction with the modified transtibial technique provides favorable clinical outcomes, high return-to-sport rates, and low failure rates, particularly among professional athletes. Meniscus preservation is crucial for optimizing post-operative recovery. Future research should focus on long-term outcomes and comparative studies with other ACL reconstruction techniques.
前交叉韧带（ACL）损伤在运动员中很常见，会显著影响其膝关节稳定性和运动表现。手术重建是标准治疗方法。改良经胫骨技术已成为一种有前景的手术方法，可实现最佳移植物定位并减少并发症。
对采用改良经胫骨技术进行初次ACL重建的运动员进行回顾性研究。使用Lysholm和国际膝关节文献委员会（IKDC）主观评分以及客观膝关节稳定性评估来评价临床结果。分析重返运动率及相关因素。
纳入44名运动员（37名男性，7名女性；平均年龄21.2±5.0岁）。平均随访27.0±12.2个月时，Lysholm和IKDC主观评分有显著改善。总体而言，88.2%的运动员重返运动，65.9%达到受伤前水平。重返受伤前水平定义为恢复受伤前相同类型、强度和频率的运动参与。职业运动员的重返受伤前运动率（79.3%）显著高于业余运动员（40.0%，P = 0.0091）。合并半月板损伤对重返运动率有负面影响（92.9%对66.7%，P = 0.0397）。总体失败率为4.6%（2/44；95%置信区间[CI]：0.6 - 15.5%），有2例移植物功能不全或再次断裂。
改良经胫骨技术进行ACL重建可提供良好的临床结果、高重返运动率和低失败率，尤其是在职业运动员中。保留半月板对优化术后恢复至关重要。未来研究应关注长期结果以及与其他ACL重建技术的比较研究。
