BACKGROUND: Our study aims to assess the effectiveness of multicomponent supervised tele-rehabilitation compared to home-based self-rehabilitation management in patients following anterior cruciate ligament reconstruction (ACLR).
METHODS: The current study is designed as a single-center, single-blinded, randomized controlled, two-arm trial. Participants will be randomized and allocated at a 1:1 ratio into either a multicomponent supervised tele-rehabilitation group or a home-based self-rehabilitation group. All participants receive uniform preoperative education through the HJT software. Participants in the intervention group undergo multicomponent supervised tele-rehabilitation, while those in the control group follow a home-based self-rehabilitation program. All the participants were assessed and measured for the included outcomes at the outpatient clinic before the procedure, and in 2, 4, 8, 12, and 24 weeks after ACLR by two assessors. The primary outcome was the percentage of patients who achieve a satisfactory active ROM at the 12 weeks following the ACLR. The satisfactory active ROM was also collected at 2, 4, 8, and 24 weeks after ACLR. The secondary outcomes were active and passive range of motion (ROM), pain, muscle strength, and function results.
BACKGROUND: Ethical approval has been obtained from the West China Hospital Ethics Committee (approval number 2023-1929, December 2023). The trial has been registered on ClinicalTrials.gov (registration number NCT06232824, January 2024).

UNASSIGNED: To compare the short-term effectiveness of suture hook suture via double posteromedial approaches and Fast-Fix total internal suture in treatment of Ramp lesions.
UNASSIGNED: A clinical data of 56 patients with anterior cruciate ligament rupture combined with Ramp lesions, who met the selection criteria and admitted between December 2021 and February 2023, was retrospectively analyzed. The Ramp lesions were sutured using suture hook via double posteromedial approaches under arthroscopy in 28 cases (group A) and treated with Fast-Fix total internal suture under arthroscopy in 28 cases (group B). There was no significant difference in age, gender, cause of injury, type of injury, time from injury to operation, side of injury, body mass index, and preoperative Lysholm score, visual analogue scale (VAS) score, and Tegner score between the two groups ( P>0.05). The patients were followed up regularly after operation, and the clinical and imaging healing of the Ramp lesion was evaluated according to the Barrett clinical healing standard and the MRI evaluation standard. Lysholm score, VAS score, and Tegner score were used to evaluate the function and pain degree of knee joint, and the results were compared with those before operation.
UNASSIGNED: The incisions of the two groups healed by first intention. All patients were followed up 12-18 months (mean, 14.9 months). Postoperative McMurray tests were negative in both groups. The clinical healing rates of group A and group B were 71.4% (20/28) and 64.3% (18/28) at 6 months after operation, and 92.9% (26/28) and 82.1% (23/28) at 12 months after operation, respectively. The differences between the two groups was not significant ( χ 2=0.327, P=0.567; χ 2=0.469, P=0.225). There was no significant difference in Lysholm score, VAS score, and Tegner score between the two groups at each time point after operation ( P>0.05). The postoperative scores in the two groups significantly improved when compared with those before operation, and the scores at 12 months after operation further improved when compared with those at 6 months after operation, showing significant differences between the different time points in the two groups ( P<0.05). At last follow-up, MRI examination of the knee joint showed that there were 26 (92.9%), 2 (7.1%), and 0 (0) cases of complete healing, partial healing, and nonunion in the Ramp lesion of group A, and 25 (89.3%), 1 (3.6%), and 2 (7.1%) cases in group B, respectively. There was no significant difference between the two groups ( Z=-0.530, P=0.596).
UNASSIGNED: Suture hook suture via double posteromedial approaches and Fast-Fix total internal suture under arthroscopy are safe and reliable in the treatment of Ramp lesion, and the knee joint function significantly improves after operation.
UNASSIGNED: 比较关节镜下双后内侧入路缝合钩缝合与Fast-Fix全内缝合治疗Ramp损伤的早期疗效。.
UNASSIGNED: 回顾分析2021年12月—2023年2月收治且符合选择标准的56例前交叉韧带断裂合并Ramp损伤患者临床资料。其中，采用关节镜下双后内侧入路缝合钩缝合28例（A组），关节镜下Fast-Fix全内缝合28例（B组）。两组患者年龄、性别、致伤原因、损伤类型、受伤至手术时间、损伤侧别、身体质量指数及术前膝关节Lysholm评分、疼痛视觉模拟评分（VAS）及Tegner评分等基线资料比较，差异均无统计学意义（ P>0.05）。术后患者定期随访，参照Barrett临床愈合标准以及MRI评价标准评估Ramp区域临床及影像愈合情况；采用Lysholm评分、VAS评分及Tegner评分评价膝关节功能及疼痛程度，并与术前评价结果进行比较。.
UNASSIGNED: 两组术后切口均Ⅰ期愈合。患者均获随访，随访时间12～18个月，平均14.9个月。两组McMurray试验均为阴性。A、B组术后6个月临床愈合率分别为71.4%（20/28）、64.3%（18/28），12个月时分别为92.9%（26/28）、82.1%（23/28），组间差异均无统计学意义（ χ 2=0.327， P=0.567； χ 2=0.469， P=0.225）。两组间术后各时间点Lysholm评分、VAS评分及Tegner评分比较，差异均无统计学意义（ P>0.05）；两组内术后各项评分均较术前改善，12个月时较6个月时进一步改善，差异均有统计学意义（ P<0.05）。末次随访时，膝关节MRI复查示A组Ramp区域达完全愈合、部分愈合、未愈合分别有26例（92.9%）、2例（7.1%）、0例（0），B组为25例（89.3%）、1例（3.6%）、2例（7.1%），两组差异无统计学意义（ Z=−0.530， P=0.596）。.
UNASSIGNED: 关节镜下双后内侧入路缝合钩缝合与Fast-Fix全内缝合治疗Ramp损伤均安全可靠，术后早期患者膝关节功能显著改善。.

BACKGROUND: This study aimed to investigate the feasibility and precision of using a 3D-printed template for femoral tunnel placement in guiding the optimal positioning of the Internal anatomical stop and Low tension maintenance (IDEAL) bone tunnel during single-bundle anterior cruciate ligament (ACL) reconstruction.
METHODS: A retrospective analysis was conducted on 40 patients who underwent arthroscopic single-bundle ACL reconstruction at our hospital between April 2021 and November 2021. In the direct vision group, the IDEAL bone tunnel was positioned using radiofrequency localization directly visualized at the stump. In the 3D-printed positioning group, preoperative CT scans and Digital Imaging and Communications in Medicine (DICOM) data were employed. Following the Quadrant method by Bernard, the femoral tunnel\'s depth was set at 25% and its height at 29%. Postoperative plain CT scans enabled the reconstruction of 3D models for both groups. The accuracy of femoral tunnel placement was then compared.
RESULTS: The central locations of the bone tunnels in the direct vision group were at a mean depth of 25.74 ± 1.84% and a height of 29.22 ± 2.97%. In the 3D printing localization group, these values were 25.39 ± 2.98% for depth and 28.89 ± 2.50% for height, respectively. No significant differences were found in tunnel positioning between the groups. Both groups demonstrated statistically significant improvements in International Knee Documentation Committee Subjective Knee Form (IKDC) and Lysholm scores postoperatively, with no significant differences observed 12 months post-surgery.
CONCLUSIONS: The findings of this study suggest that 3D printing-assisted arthroscopic IDEAL point femoral tunnel positioning and conventional arthroscopic positioning are feasible and effective for ACL reconstruction. Using 3D printing technology to design femoral anchor points in ACL reconstruction allows for the customization of anterior fork reconstruction and precise bone tunnel positioning, supporting the goal of individualized and accurate reconstruction.

BACKGROUND: To investigate the outcome and prognosis after Unicondylar knee arthroplasty (UKA) in patients with medial compartment arthritis of the knee combined with anterior cruciate ligament(ACL) dysfunction.
METHODS: A total of 122 patients diagnosed with knee osteoarthritis and treated with medial mobile platform unicondylar replacement at our center from January 2019 to December 2021 were retrospectively included in the study, and were divided into two groups according to ACL function, namely the normal ACL function group (ACLF) and the poor ACL function (N-ACLF) group. The postoperative results and prognosis of the two groups were evaluated and compared.
RESULTS: This study included 122 patients who underwent UKA surgery. There were no statistical differences in preoperative and postoperative posterior tibial tilt angle, knee mobility, KOOS, and prognosis between the two groups (P > 0.05).
CONCLUSIONS: For medial compartment arthritis of the knee combined with ACL malfunction, surgery resulted in pain relief, improved quality of life and a good prognosis for such patients. It is hoped that clinicians will perform UKA in patients with ACL dysfunction after a comprehensive evaluation to improve their quality of life.

暂无摘要。

OBJECTIVE: We describe a surgical technique for ACL reconstruction combined with anterolateral structure reinforcement and report early clinical follow-up results.
METHODS: The semitendinosus and gracilis tendons are braided into 5 strands and the ACL femoral tunnel and tibial tunnel are created. The graft is passed through the tunnel with the use of a traction suture and the tibial end is fixed with absorbable interference screws at 30° of knee flexion. The ACL graft traction suture is used as an anterolateral reconstruction structure to pass through the proximal exit of the ACL femoral tunnel and then through the depth of the iliotibial bundle to the anterior to Gerdy\'s tubercle, a bony tunnel is created from the anterior to Gerdy\'s tubercle to the goose foot, and the traction suture is passed through this bony tunnel to form a Loop structure at 20° of knee flexion. Between March 2021 and May 2022 IKDC score, Lysholm score, and Tegner score were performed preoperatively and 6-12 months postoperatively in 24 consecutive patients who met the indications for this procedure and underwent surgery. The patient\'s maximum flexion angle, the circumference of the thigh, and the stress X-ray between the operated and healthy knee were measured.
RESULTS: Patients showed significant improvement in IKDC score, Lysholm score and Tegner score at a mean follow-up of 7 months postoperatively compared to preoperatively. No significant increase in anterior tibial displacement was found between the patient\'s operated side and the healthy side.
CONCLUSIONS: The Loop technique ACLR combined with ALSA can be used in patients with an ACL tear combined with a high degree of positive pivot shift. The patient\'s subjective perception was significantly improved from the preoperative period and knee stability was restored.
METHODS: IV, therapeutic study.

OBJECTIVE: The objectives of this paper is to conduct a bibliometric analysis to examine the research status and development trend of anterior cruciate ligament injury and reconstruction in children and adolescents over the past 20 years.
METHODS: Descriptive Research.
METHODS: This study obtained information regarding studies on Anterior Cruciate Ligament Reconstruction in Children and Adolescents from the Web of Science Core Collection database. Visual and bibliometric analysis were conducted using VOSviewer, Origin 2022, Pajek64 5.18and Excel 2019. These analytic tools facilitated the analysis of various aspects, including countries/regions, institutions, authors, journals and keywords related to the research.
RESULTS: From 2003 to 2023, a total of 1328 articles were retrieved in WOS, and 637 articles were selected by two authors. The most productive institutions are Childrens Hosp Philadelphia, Kocher, ms. Their articles have the highest number of publications and citations. The American journal of sports medicine is the most frequently cited journal for articles on anterior cruciate ligament reconstruction in children and adolescents. The most common keywords used in these articles were \"anterior cruciate ligament reconstruction\", \"injury, children, adolescent\", and \"skeletally immature patients\".
CONCLUSIONS: This study provides valuable insights into the research focus of anterior cruciate ligament reconstruction in children and adolescents. In recent years, there has been significant attention paid to areas of \"the return to sport, re-repture rate and functional recovery after anterior cruciate ligament reconstruction\" in this specific population. These aspects have emerged as key directions for future research in this field.

Despite significant advancements in surgical instruments and operation skills, short- and long-term outcomes following anterior cruciate ligament reconstruction (ACLR) remain unsatisfactory, as many patients fail to return to their pre-injury level of sports. Inadequate ACL rehabilitation is the primary cause of poor outcomes. Nurses have become a crucial element in the rehabilitation process. Although there is no consensus regarding the optimal post-operative rehabilitation protocols, restoring muscle strength and neuromuscular control are consistently the primary goals. This literature review presents nurse-assisted rehabilitation protocols aiming at improving muscle strength and neuromuscular control. The review discusses postoperative rehabilitation, including home-based and supervised rehabilitation, open and closed kinetic chain exercises, eccentric and concentric training, blood flow restriction training, and plyometric training. Each training protocol has its benefits and drawbacks, and should be used cautiously in specific stages of rehabilitation. Neuromuscular training, such as neuromuscular electrical stimulation, neuromuscular control exercises, and vibration therapy, is considered crucial in rehabilitation.

OBJECTIVE: To perform a meta-analysis to compare clinical outcomes of anterior cruciate ligament (ACL) repair and ACL reconstruction for acute ACL rupture.
METHODS: We searched Pubmed, Embase, the Cochrane Library, and Web of Science databases to seek relevant studies. Clinical outcomes included failure rate, hardware removal rate, anteroposterior (AP) knee laxity, and patient-reported outcomes. In addition, subgroup analysis was carried out according to repair techniques, rupture locations, and study designs. Funnel plots were used to detect publication bias. All statistical analysis was performed using STATA (version 14.2, StataCorp).
RESULTS: A total of 10 articles were included in this study, comprising 5 randomized controlled trials (RCTs) and 5 cohort studies, involving a total of 549 patients. We found no statistical differences between the ACL repair and ACL reconstruction in the following outcomes: failure rate, AP knee laxity, International Knee Documentation Committee (IKDC) score, Lysholm score, Knee Injury and Osteoarthritis Outcome (KOOS) Score, and Tegner score. However, the ACL repair group had a higher hardware removal rate. Except for AP knee laxity results on different repair techniques, there was no statistical difference in other subgroup analyses.
CONCLUSIONS: Compared with ACL reconstruction, ACL repair shows similar results in clinical outcomes, and it is promising to be an effective alternative treatment for acute ACL rupture. Larger samples and higher-quality studies are needed to support our results and further explore the advantages of ACL repair in other aspects.
METHODS: Level III.

UNASSIGNED: To explore the early effectiveness and influence on cartilage of local injection of multimodal drug cocktail (MDC) during anterior cruciate ligament reconstruction (ACLR).
UNASSIGNED: Between February 2022 and August 2023, patients undergone arthroscopic ACLR using autologous hamstring tendons were selected as the study subjects. Among them, 90 patients met the selection criteria and were randomly divided into 3 groups ( n=30) according to the different injection drugs after ligament reconstruction. There was no significant difference in baseline data such as gender, age, body mass index, surgical side, disease duration, preoperative thigh circumference, and preoperative levels of tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), IL-1, matrix metalloproteinase 3 (MMP-3), MMP-13, and aggrecan (ACAN) in synovial fluid between groups ( P>0.05). After the ligament reconstruction during operation, corresponding MDC (consisting of ropivacaine, tranexamic acid, and betamethasone in group A, and ropivacaine, betamethasone, and saline in group B) or saline (group C) were injected into the joint and tendon site, respectively. The length of hospital stay, postoperative tramadol injection volume, incidence of complications, degree of knee joint swelling and range of motion, visual analogue scale (VAS) score, International Knee Documentation Committee (IKDC) score, Lyshlom score, and Hospital for Special Surgery (HSS) score were recorded and compared between groups. The T2 * values in different cartilage regions were detected by MRI examination and the levels of TNF-α, IL-6, IL-1, MMP-3, MMP-13, and ACAN in synovial fluid were detected by ELISA method.
UNASSIGNED: The patients in group A, B, and C were followed up (12.53±3.24), (13.14±2.87), and (12.82±3.32) months, respectively. All incisions healed by first intention. Compared with group C, group A and group B had shorter length of hospital stay, less tramadol injection volume, and lower incidence of complications, showing significant differences ( P<0.05); there was no significant difference between group A and group B ( P>0.05). The degree of knee swelling in group A was significantly less than that in group B and group C ( P<0.05), but there was no significant difference between group B and group C ( P>0.05). At 3, 6, 12, 24, and 48 hours after operation, VAS scores of group A and group B were significantly lower than those of group C ( P<0.05); at 72 hours after operation, there was no significant difference among the three groups ( P>0.05). At 3 days, 14 days, and 1 month after operation, the range of motion of knee joint in group A were significantly better than those in group C ( P<0.05), and there was no significant difference between the other groups ( P>0.05). At 1 month after operation, the IKDC score of group A and group B was significantly higher than that of group C ( P<0.05); there was no significant difference among the three groups at other time points ( P>0.05). There was no significant difference in Lyshlom score and HSS score among the three groups at each time point ( P>0.05). At 14 days after operation, the levels of IL-1 and IL-6 in the synovial fluid in groups A and B were significantly lower than those in group C ( P<0.05). There was no significant difference in the levels of TNF-α, MMP-3, MMP-13, and ACAN between groups A and B ( P>0.05). At 1 month after operation, there was no significant difference in the above indicators among the three groups ( P>0.05). At 3, 6, and 12 months after operation, there was no significant difference in the T2 * values of different cartilage regions among the three groups ( P>0.05).
UNASSIGNED: Injecting MDC (ropivacaine, tranexamic acid, betamethasone) into the joint and tendon site during ACLR can achieve good early effectiveness without significant impact on cartilage.
UNASSIGNED: 探讨前交叉韧带重建术（anterior cruciate ligament reconstruction，ACLR）中局部注射多模式混合药物（multimodal drug cocktail，MDC）的早期疗效及对软骨的影响。.
UNASSIGNED: 以2022年2月—2023年8月拟采用自体腘绳肌腱行关节镜下ACLR患者作为研究对象，其中90例符合选择标准纳入研究，根据韧带重建后注射药物不同随机分为3组（ n=30）。3组患者性别、年龄、身体质量指数、手术侧别、病程以及术前大腿周径及关节液中TNF-α、IL-6、IL-1、基质金属蛋白酶3（matrix metalloproteinase 3，MMP-3）、MMP-13、聚集蛋白聚糖（aggrecan，ACAN）含量等基线资料比较，差异均无统计学意义（ P>0.05）。术中韧带重建后，分别于关节内和取腱处注射对应MDC（A组由罗哌卡因、氨甲环酸、倍他米松组成，B组由罗哌卡因、倍他米松、生理盐水组成）或生理盐水（C组）。比较3组患者住院时间、术后曲马多注射量及并发症发生情况，膝关节肿胀程度及活动度、疼痛视觉模拟评分（VAS）、国际膝关节文献委员会（IKDC）评分、Lyshlom评分以及美国特种外科医院（HSS）评分；MRI检查不同软骨区域T2 *值；ELISA法检测关节液中TNF-α、IL-6、IL-1、MMP-3、MMP-13、ACAN含量。.
UNASSIGNED: 3组患者均获随访，A、B、C组随访时间分别为（12.53±3.24）、（13.14±2.87）、（12.82±3.32）个月。术后切口均Ⅰ期愈合。A、B组与C组相比，住院时间缩短、曲马多注射量减少、并发症发生率降低，差异均有统计学意义（ P<0.05）；A、B组间差异均无统计学意义（ P>0.05）。术后A组膝关节肿胀程度较B、C组减轻（ P<0.05），B、C组间差异无统计学意义（ P>0.05）。术后3、6、12、24、48 h时，A、B组VAS评分低于C组（ P<0.05）；术后72 h时3组间差异均无统计学意义（ P>0.05）。术后3 d、14 d、1个月，A组膝关节活动度优于C组（ P<0.05），其余组间比较差异无统计学意义（ P<0.05）。术后1个月时，A、B组IKDC评分高于C组（ P<0.05）；其余时间点组间比较差异均无统计学意义（ P>0.05）。各时间点Lyshlom评分及HSS评分组间比较差异均无统计学意义（ P>0.05）。ELISA检测术后14 d A、B组患膝关节液中IL-1和IL-6含量低于C组（ P<0.05），TNF-α、MMP-3、MMP-13、ACAN含量差异均无统计学意义（ P>0.05）；A、B组上述指标差异均无统计学意义（ P>0.05）。术后1个月时，上述各项指标组间比较差异均无统计学意义（ P>0.05）。术后3、6、12个月时，3组间各软骨区域T2 *值比较差异均无统计学意义（ P>0.05）。.
UNASSIGNED: ACLR术中关节内联合取腱处注射MDC（罗哌卡因、氨甲环酸、倍他米松）可获得良好早期疗效，且对软骨无明显影响。.