Comparative research progress on the application of interference screws and adjustable-length loop in anterior cruciate ligament reconstruction
10.3760/cma.j.cn121113-20230817-00102
- VernacularTitle:界面螺钉与可调节襻钛板重建前十字韧带的研究进展
- Author:
Bin WU
1
;
Jianhao FENG
;
Weidong XU
Author Information
1. 海军军医大学第一附属医院（上海长海医院）关节骨病外科，上海 200433
- Keywords:
Knee joint;
Anterior cruciate ligament reconstruction;
Transplants;
Tenodesis;
Interference screws;
Adjustable-length loop
- From:
Chinese Journal of Orthopaedics
2024;44(9):629-635
- CountryChina
- Language:Chinese
-
Abstract:
For patients with anterior cruciate ligament (ACL) injuries, arthroscopic anterior cruciate ligament reconstruction (ACLR) is the primary method to restore function. The positioning and creation of bone tunnels, graft selection, and fixation methods are crucial to the effectiveness of ACLR. Improper graft fixation can lead to bone tunnel enlargement, graft laxity, and ultimately, ACL reconstruction failure and revision. Thus, the graft fixation method is pivotal for ACLR. Over the past 40 years, significant progress has been made in ACLR under arthroscopy, leading to a more consistent surgical philosophy and more standardized surgical techniques. The most commonly used graft fixation methods are interference screws (IS) and adjustable-length loops (ALP). IS involves compression fixation within the bone tunnel, while ALP is a widely used cortical suspensory fixation method. Compared to IS, ALP offers advantages such as more secure fixation, higher strength, no graft damage, and promotion of tendon-bone healing. It also reduces the inflammatory response, minimizes bone tunnel enlargement, cortical bone membrane damage, and postoperative pain. Consequently, ALP has gained increasing attention and adoption in clinical practice. Currently, the fixation method on the femoral side has been generally unified, while the optimal fixation method on the tibial side remains controversial. Domestic guidelines suggest that both IS and ALP fixation are acceptable. However, surgeons should have a comprehensive understanding of each fixation method. This article systematically compares the clinical applications and research progress of IS and ALP fixation, providing clinicians with a more suitable choice for fixation method.
