Nhận xét kết quả phẫu thuật nội soi tái tạo dây chằng chéo trước khớp gối bằng kỹ thuật một bó bảo tồn gốc dây chằng tại Bệnh viện Nhân dân 115

The anterior cruciate ligament (ACL) plays a critical role in knee joint stability and proprioception, and its injury is among the most common ligamentous knee traumas, often leading to chronic instability and early osteoarthritis if not treated effectively. While arthroscopic ACL reconstruction is the standard treatment, advancements focus on optimizing graft placement and fixation to enhance recovery and minimize complications. Specifically, the technique of single-bundle remnant-preserving ACL reconstruction has gained interest due to its potential benefits, including maintaining vascularity and proprioceptive receptors from the remaining tissue. However, systematic evaluation of its efficacy within the Vietnamese population remains limited. This study aims to address this gap by describing the clinical and paraclinical characteristics and evaluating the outcomes of this particular procedure at a major local hospital.

Orthopedic surgeons, sports medicine specialists, physical therapists, and researchers interested in anterior cruciate ligament reconstruction techniques and patient outcomes.

This retrospective case series investigated the clinical and paraclinical outcomes of arthroscopic single-bundle remnant-preserving anterior cruciate ligament reconstruction in 78 patients at 115 People's Hospital between January 2024 and January 2025. The study enrolled patients with an average age of 27.9 ± 6.2 years, predominantly male (70.5%), with sports-related injuries being the most common cause (58.9%). The mean interval from injury to surgery was 4.3 ± 4.9 months, and the mean operative time was 43.8 ± 8.6 minutes. Postoperative assessment revealed that pain peaked at 24 hours and rapidly subsided. Knee flexion improved quickly, reaching less than 90 degrees at discharge and full range by six months post-operation. Notably, at the six-month follow-up, the average Lysholm score significantly increased from 55.4 ± 8.7 to 91.8 ± 6.1, with 92.3% of patients achieving good to excellent results. Furthermore, 96.1% were graded A or B according to the International Knee Documentation Committee (IKDC) scores. Knee stability tests, including Lachman (96.1% negative) and Pivot Shift (100% negative), demonstrated excellent recovery. The Limb Symmetry Index (LSI) improved substantially from 67.4 ± 9.2 to 92.6 ± 5.4, indicating near-complete limb strength restoration. Crucially, no complications or graft failures were recorded within the study period.

The findings suggest that single-bundle remnant-preserving arthroscopic anterior cruciate ligament reconstruction is a safe and effective technique, leading to favorable functional outcomes, enhanced knee stability, and rapid recovery in the studied population. This approach offers a promising alternative for anterior cruciate ligament repair, particularly in younger, active patients, by leveraging the potential benefits of preserving remaining tissue. However, the study acknowledges limitations, including a relatively short follow-up period of six months, which may not fully capture long-term outcomes, return to high-level sports activities, or the incidence of late osteoarthritis. Further comparative studies with longer follow-up are recommended to validate these findings and firmly establish the long-term advantages of this technique.