A Comparative Study Of Clinical Efficacy Between All-inside Single Bundle Reconstruction Of Anterior Cruciate Ligament And Traditional Single Bundle Reconstruction Of Anterior Cruciate Ligament

Objective: To compare the clinical effect of the anterior cruciate ligament all-inside single bundle reconstruction and tradtional single bundle reconstruction through prospective randomized controlled clinical trials.Methods: From September 2018 to July 2019,54 patients who met the inclusion criteria were included in the study,signed informed consent,sorted according to the time of admission,and randomly assigned to the anterior cruciate ligament single bundle reconstruction group(all-inside group,n=27)and the anterior cruciate ligament traditional single bundle reconstruction group(traditional group,n=27)according to the random number table method.The operation was performed by the same group of doctors.The amount of tendon was recorded during the operation,Tegner,IKDC,Lysholm,and VAS scores were recorded during the preoperative and postoperative follow-up 3,6,and 12 months.The widening of tunnel diameter was measured by CT and anterior cruciate ligament SNR was measured by MRI at the 3,6,and 12 months after the follow-up.GNRB arthrometer(Genourob,France)was used to evaluate the relative anterior movement of the tibia at 12 months after the operation.Results: The all-inside group significantly saved tendons((6.6±0.2)cm VS(8.1±0.3)cm,P<0.05).The VAS pain score of the all-inside group was lower than the normal group at3 months after surgery((1.67±2.15)VS(2.44±1.67),P=0.016)and at 12 months after surgery((0.25±0.45)VS(0.89±1.15),P=0.013).The tibial tendon channel widening of the all-inside group was significantly lower than that of the traditional group at 3months after operation((1.32±1.52)mm VS(2.23±1.49)mm,P<0.05),6 months after operation((0.54±1.53)mm VS(1.32±1.46)mm,P<0.05)and 12 months after operation((-0.07±1.62)mm VS(1.06±1.31)mm,P<0.05).There was no statistical difference in femoral tunnel widening between the two groups.The SNR of the anterior cruciate ligament was higher in the middle((69.99±27.12)VS(57.13±34.83),P<0.05)and distal((52.44±23.87)VS(41.95±28.88),P<0.05)anterior cruciate ligament in the all-inside group at 6 months after surgery.There was no statistical difference in SNR between the two groups in 3 months and 12 months after surgery.The SNR of the all-inside group showed an upward trend in the early and mid-term follow-up,and gradually decreased in the later period,while the SNR of the traditional group gradually increased over time.There was no statistical difference between the two groups in Tegner score,IKDC score,Lysholm score,and data of GNRB mersuring.Conclusion: There is no statistical difference in postoperative functional recovery and stability between the anterior cruciate ligament all-inside single bundle reconstruction technique and the traditional single bundle reconstruction technique,but the all-inside technique is significantly better than the traditional technique in terms of tibial tunnel widening,pain improvement and tendon saving.Tendon maturity of the all-inside technique group shows a downward trend in the early and mid-term but gradually improves in the later stage,while the tendon maturity of traditional technique group is better than that of the all-inside technique in the early and mid-term,but gradually decreases over time.