Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2023; 11(14): 3195-3203
Published online May 16, 2023. doi: 10.12998/wjcc.v11.i14.3195
Comparative study of the clinical efficacy of all-inside and traditional techniques in anterior cruciate ligament reconstruction
Bai-Jing An, Yao-Ting Wang, Zhe Zhao, Ming-Xin Wang, Geng-Yan Xing
Bai-Jing An, Yao-Ting Wang, Zhe Zhao, Ming-Xin Wang, Geng-Yan Xing, Department of Sports Medicine, The Fourth Medical Center of PLA General Hospital, Beijing 100000, China
Author contributions: Xing GY designed the research study; Wang YT, Zhao Z and Wang MX performed the research; An BJ analyzed the data and wrote the manuscript; All authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Third Medical Center of PLA General Hospital Institutional Review Board, No. KY2021-040.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrollment.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at xinggengyan123@163.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Geng-Yan Xing, FCCP, Dean, Director, Doctor, Professor, Surgeon, Department of Sports Medicine, The Fourth Medical Center of PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing 100000, China. xinggengyan123@163.com
Received: November 20, 2022
Peer-review started: November 20, 2022
First decision: February 14, 2023
Revised: March 5, 2023
Accepted: April 4, 2023
Article in press: April 4, 2023
Published online: May 16, 2023
Processing time: 176 Days and 22.5 Hours
Abstract
BACKGROUND

Many studies have focused on the femoral tunnel technique and fixation method, but few studies have involved the tibial tunnel technique and fixation method. The all-inside technique is one of the new techniques that has been described in recent years. All-inside anterior cruciate ligament (ACL) reconstruction is based on a tibial socket instead of a full tunnel. This method has many potential advantages.

AIM

To compare clinical outcomes of knee ACL autograft reconstruction using all-inside quadrupled semitendinosus (AIST) and traditional hamstring tendon (TBT) techniques.

METHODS

From January 2017 to October 2019, the clinical data of 80 patients with ACL reconstruction were retrospectively analyzed, including 67 males and 13 females. The patients had an average age of 24.3 ± 3.1 years (age range: 18-33 years). The AIST technique was used in 42 patients and the TBT technique was used in 38 patients. The time between operation and injury, operative duration, postoperative visual analogue scale (VAS) score and knee functional recovery were recorded and compared between the two groups. The International Knee Documentation Committee (IKDC) and Lysholm scoring system were used to comprehensively evaluate clinical efficacy.

RESULTS

Eighty patients were followed for 24-36 mo, with an average follow-up duration of 27.5 ± 1.8 mo. There were no significant differences in the time between surgery and injury, operative duration, IKDC and Lysholm scores of the affected knee at the last follow-up evaluation between the two groups. There were significant differences in VAS scores 1 d, 3 d, 7 d, 2 wk and 1 mo after surgery (P < 0.05). There was no significant difference in VAS score at 3 mo, 6 mo and 1 year after operation.

CONCLUSION

The efficacy of the AIST ACL reconstruction technique was comparable to the TBT technique, but the postoperative pain was less with the AIST technique. Thus, the AIST technique is an ideal treatment choice for ACL reconstruction.

Keywords: Anterior cruciate ligament reconstruction; All-inside quadrupled semitendinosus; Clinical curative effect; Traditional hamstring tendon; Visual analogue scale

Core Tip: This study retrospectively analyzed 80 patients with anterior cruciate ligament (ACL) injuries who underwent all-inside quadrupled semitendinosus (AIST) or traditional hamstring tendon (TBT). We demonstrated that there were no significant differences in the time between surgery and injury, operative duration, International Knee Documentation Committee and Lysholm scores of the affected knee. However, there were significant differences in visual analogue scale scores 1 d, 3 d, 7 d, 2 wk and 1 mo after surgery (P < 0.05). These results indicated the efficacy of the AIST ACL reconstruction technique was comparable to the TBT technique, but the postoperative pain was less with the AIST technique. Thus, the AIST technique is a better choice for ACL reconstruction.