Comparison Of Curative Effect Between All-inside Technique And Traditional Arthroscopic Anterior Cruciate Ligament Reconstruction In Patients With Anterior Cruciate Ligament Tear: A Meta-analysis

Background: Anterior cruciate ligament(ACL)tear of the knee joint is common in sports injuries,primarily affecting females.Untimely and inappropriate treatment of ACL tear can result in long-term disabilities.Surgery is the recommended treatment for patients with ACL tears.The minimally invasive surgery for ACL reconstruction under knee arthroscopy is more popular with doctors and patients.The total medial anterior cruciate ligament reconstruction technology is gradually promoted in recent years.Our purpose is to compare the effect of total internal technique and traditional operation on reconstruction of torn anterior cruciate ligament of knee joint through this study.Methods: Pub Med,Embase,Web of Science,Cochrane Library,CNKI,Wanfang Database,and VIP Database were searched until January 31,2023.A meta-analysis was conducted to compare postoperative Lysholm、IKDC(International Knee Documentation Committee)、VAS(Visual Analog Scale)、Tegner、KSS(Knee Society Score)、KOOS(Knee Injury and Osteoarthritis Outcome Score),and KT-1000 evaluation indices,as well as operative duration,graft length,graft diameter(thickness),femoral tunnel length,tibial tunnel length,and postoperative tibial bone tunnel widening during regular follow-up between the two procedures through a forest plot.Results: Nineteen studies involving 1568 patients with ACL tear were included in the meta-analysis,with 769 patients undergoing complete medial anterior cruciate ligament reconstruction technique and 799 patients undergoing traditional surgical techniques.The results of the meta-analysis showed no statistically significant differences in Lysholm,IKDC,Tegner,KSS,KOOS,KT-1000,operative duration,or femoral tunnel length between the two procedures;95% confidence interval(CI)P > 0.05.VAS had no statistical significance on postoperative day 1 and day 3,but after excluding one group of data through sensitivity analysis,it remained statistically significant on postoperative day7(WMD=-1.34;95%CI:-2.40,-0.28;P=0.01<0.05).Graft length(WMD=-4.98;95%CI:-6.44,-3.52;P<0.00001),graft diameter(thickness)(WMD=0.87;95%CI: 0.66,1.09;P<0.00001),tibial tunnel length(WMD=-1.98;95%CI:-2.32,-1.6;P<0.05),and postoperative tibial bone tunnel widening(WMD=-1.27;95%CI:-1.57,-0.98;P<0.00001)had statistical significance.Conclusion: This meta-analysis found no significant differences in postoperative knee joint function evaluation indicators between two surgical procedures.However,compared to traditional techniques,the all-inside reconstruction technique results in less bone damage,reduced requirement for internal implants,and shorter duration of postoperative pain.Nevertheless,these conclusions need to be confirmed through further research that integrates more standardized data collection methods and large-scale prospective clinical trials.And there was no significant statistical difference in knee joint function evaluation indicators between the two surgical procedures in the short and long term.Due to the limitations of this study,further exploration through large-scale,prospective studies is needed to determine the superiority or inferiority of these two surgical techniques for treating ACL rupture.In clinical practice,surgeons should select the appropriate surgical method based on the individual characteristics of each patient to minimize the occurrence of postoperative complications and accelerate the recovery of knee joint function.