| Purpose:To compare the difference of early efficacy of singlebundle reconstruction of adult anterior cruciate ligament using autologous tendon with All-inside and non-All-inside techniques.Methods:The clinical data of 62 patients who underwent ACLRalone were collected and analyzed in the same group of physicians in the Department of Sports Medicine and Arthrosis and Osteopathy,Changsha Central Hospital affiliated to The University of South China from January2018 to January 2020.According to the different methods of ACLR,patients were divided into All-inside group(n=30)and non-All-inside group(n=32).General information(gender,age,side of injury,BMI,operative distance injury time,etc.)of patients in All-inside group and non-All-inside group were collected,and the number of intraoperative tendon use,graft type,graft length,graft diameter,operation time,intraoperative blood loss and surgical complications were recorded.VAS score,IKDC score,Lysholm score,Tegner score,Lachman test,front drawer test,pivot shift test and return-to-sport rate of patients in All-inside group and non-All-inside group were recorded before surgery and at 1,3 months after surgery and at the last follow-up.Results:In All-inside group,there were 25 males and 5 females,the mean BMI was 24.916±4.524 kg/m~2,and the mean follow-up time was28.130±2.825 months.In non-All-inside group,there were 20 males and 12females,the mean BMI was 24.081±2.789 kg/m~2,and the mean follow-up was 38.810±6.746 months.The graft diameter in All-inside group was significantly higher than that in non-All-inside group(8.500±0.572 VS7.313±0.471,P<0.001),the graft length in All-inside internal group was significantly shorter than that in non-All-inside group(6.467±0.295 VS8.035±0.335,P<0.001),the number of graft use in All-inside group was significantly less than that in non-All-inside group(1.130±0.346 VS 2.090±0.296,P<0.001),there were significant differences in graft types between All-inside group and non-All-inside group.The operation time of All-inside group was longer than that of non-All-inside group(91.633±20.395 VS75.250±22.328,P<0.05),there were no significant differences in intraoperative blood loss,incision healing grade and length of hospital stay between All-inside group and non-All-inside group(P>0.05).VAS score,IKDC score and Lysholm score were significantly improved in All-inside group and non-All-inside group at the last follow-up(P<0.05).VAS pain score at the first month after surgery of All-inside group was lower than that of non-All-inside group(1.567±1.006 VS 2.218±0.706,P<0.05);IKDC score and Lysholm score showed no significant difference between All-inside group and non-All-inside group at each follow-up stage(P>0.05);There were significant differences in Lachman test and front drawer test between All-inside group and non-All-inside group(P<0.05),there was no difference in pivot shift test between All-inside group and non-All-inside group(P>0.05).The return-to-a-sport rate in All-inside group(80%)was higher than that in non-All-inside group(56.25%)(P>0.05),the return-to-sport level before injury rate of in All-inside group(40%)was higher than that in non-All-inside group(28.13%).In terms of complications,in non-All-inside group,there was 1 patient with graft retear(3.13%)and 3patients with saphenous nerve inferior patellar branch injury(9.38%).In All-inside group,1 patient(3.33%)developed proximal tibial deep infection at 5 months after surgery,and 1 patient(3.33%)developed injury of the inferior patellar branch of the saphenous nerve.Conclusions:1.Good clinical efficacy can be achieved in patientswith anterior cruciate ligament single bundle reconstruction by autogenous tendon with All-inside technique and non-All-inside technique;2.The early postoperative pain of All-inside technique is lighter than that of non-All-inside technique;3.The anterior and posterior stability of knee joint after All-inside technique is better than that after non-All-inside technique;4.The rate of return-to-sport after All-inside technique is higher than that after non-All-inside technique. |
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