探讨关节镜下精准修复前交叉韧带后外侧束结合切口美容缝合以改善膝关节轻度前向不稳的临床效果。

对21例膝关节轻度前向不稳的患者行关节镜下前交叉韧带后外侧束解剖修复术，同时进行前内、外侧入路的切口美容缝合。术后按标准方案进行康复训练并对患者进行1、3、6个月的随访，比较术前与随访时的膝关节稳定性（Lachman试验、前抽屉试验及轴移试验）、影像学表现（磁共振成像MRI）及国际膝关节文献委员会（IKDC）评分、Lysholm膝关节功能评分、Tegner活动水平评分并记录切口愈合情况及并发症。数据比较采用重复测量方差分析和秩和检验。

21例患者中，有19例在8周达到膝关节全范围屈伸活动，其中2例在屈曲90°时膝关节功能受限。膝关节稳定性评价：与术前Lachman试验Ⅱ度阳性相比，术后所有患者Lachman试验阴性，而前抽屉试验、轴移试验无明显变化，均为阴性。此外，膝关节术后MRI显示连续2层面前交叉韧带信号均匀且连续，韧带张力明显改善。膝关节功能评估：与术前相比，术后患者IKDC评分，Lysholm、Tegner等评分明显升高（F=55.99、105.84，Z=37.86，均为P＜0.001）。切口愈合情况：所有患者均未发生感染等不良反应，1例患者因瘢痕体质导致切口瘢痕硬化、色素沉着，且在膝关节极度屈曲时出现疼痛症状，其余患者切口愈合均为优良。

关节镜下精准修复前交叉韧带后外侧束结合切口美容缝合技术治疗膝关节轻度前向不稳定，可减少切口刺激，促进膝关节功能早期康复，远期结局尚需进一步随访观察。

To investigate the clinical outcomes of arthroscopic anatomical repair of the posterolateral bundle (PLB) of the anterior cruciate ligament (ACL) combined with cosmetic portal suturing for the treatment of mild anterior knee instability.

Twenty-one patients with mild anterior knee instability underwent arthroscopic anatomical repair of the PLB of ACL. Cosmetic suturing was simultaneously performed for the anteromedial and anterolateral portals. The patients underwent a standard rehabilitation protocol and were followed up for one to six months after surgery. Knee stability was evaluated by Lachman test, anterior drawer test (ADT), and pivot-shift test. MRI findings, and functional assessments—including the International Knee Documentation Committee (IKDC) subjective evaluation form, Lysholm knee scoring scale, and Tegner activity score—were compared between the data before surgery and data during the follow-up. Incision healing and complications were also recorded. The data were analysed by repeated variation analysis and rank sum test.

Among the 21 patients, 19 achieved full range of knee motion eight weeks after surgery, while two experienced restricted knee flexion at 90°. Knee stability: compared with preoperative grade Ⅱ positive Lachman tests, all the patients demonstrated negative Lachman tests postoperatively. The ADT and pivot-shift test remained negative. Postoperative MRI revealed uniform and continuous ACL signals across two consecutive slices, indicating significantly improved ligament tension. Functional assessment: IKDC, Lysholm, and Tegner scores after surgery were significantly higher than the preoperative values (F=55.99, 105.84, Z=37.86, all P<0.001). Incision healing: no infections or other adverse events occurred in any of the patients. One patient with a scar diathesis developed scar induration, hyperpigmentation, and localized pain during extreme knee flexion. The remaining patients achieved excellent incision healing.

Arthroscopic anatomical repair of the ACL PLB combined with cosmetic portal suturing for mild anterior knee instability can effectively minimize incision-related irritation and facilitate the early rehabilitation of knee function. Long-term outcomes warrant a further follow-up observation.