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Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Oct 28, 2021; 9(5): 411-437
Published online Oct 28, 2021. doi: 10.13105/wjma.v9.i5.411
Current and future of anterior cruciate ligament reconstruction techniques
Toshiaki Takahashi, Seiji Watanabe, Toshio Ito
Toshiaki Takahashi, Department of Sports and Health Science, Ehime University, Matsuyama 790-8577, Ehime, Japan
Seiji Watanabe, Department of Orthopedic Surgery, Ehime University Graduate School of Medicine, Toon 791-0295, Ehime, Japan
Toshio Ito, Department of Orthopaedic Surgery, Murakami Memorial Hospital, Saijo 793-0030, Ehime, Japan
Author contributions: Takahashi T performed and wrote the paper; Watanabe S and Ito T performed the collected the references.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Toshiaki Takahashi, MD, PhD, Professor, Department of Sports and Health Science, Ehime University, 3 Bunkyo-cho, Matsuyama 790-8577, Ehime, Japan. takahast@m.ehime-u.ac.jp
Received: March 31, 2021
Peer-review started: March 31, 2021
First decision: July 28, 2021
Revised: August 13, 2021
Accepted: September 10, 2021
Article in press: September 10, 2021
Published online: October 28, 2021
Processing time: 211 Days and 3 Hours
Abstract

In recent years, anterior cruciate ligament (ACL) reconstruction has generally yielded favorable outcomes. However, ACL reconstruction has not provided satisfactory results in terms of the rate of returning to sports and prevention of osteoarthritis (OA) progression. In this paper, we outline current techniques for ACL reconstruction such as graft materials, double-bundle or single-bundle reconstruction, femoral tunnel drilling, all-inside technique, graft fixation, preservation of remnant, anterolateral ligament reconstruction, ACL repair, revision surgery, treatment for ACL injury with OA and problems, and discuss expected future trends. To enable many more orthopedic surgeons to achieve excellent ACL reconstruction outcomes with less invasive surgery, further studies aimed at improving surgical techniques are warranted. Further development of biological augmentation and robotic surgery technologies for ACL reconstruction is also required.

Keywords: Anterior cruciate ligament reconstruction; Surgical techniques; Revision surgery; Biological augmentation; Computer-aided surgery

Core Tip: Although anterior cruciate ligament (ACL) reconstruction has offered great benefits, particularly to athletes and physical laborers, there is a great deal of room for improvement through technology development aimed at achieving more excellent outcomes and restoring performance to a level equal to or higher than before the injury. The all-inside ACL reconstruction technique is a relatively new, minimally invasive method in which both femoral and tibial tunnels are drilled from inside the joint, and its advantages include less postoperative pain and less bleeding. A new computer-aided ACL reconstruction system with high efficacy needs to be developed.