To investigate the clinical efficacy of reverse suspension fixation in the treatment of the knee anterior cruciate ligament (ACL) and anterolateral structure (ALS) injuries under arthroscopy, and this provide a new basis for surgical improvement.

The patients with ACL and ALS injuries were enrolled in Zhongshan Hospital of Traditional Chinese Medicine from January 2017 to January 2020. Single-bundle ACL reconstructions and reverse suspension fixation ALS reconstructions were performed using the anterior-medial and anterior-lateral approach via knee flexor under arthroscope. The knee function and rotational stability of the patients were evaluated before the surgery, 12 and 18 months after the surgery. The data were compared using the repeated measures analysis or multi-sample rank-sum test.

A total of 50 patients were included for analysis with the follow-up time of (26±4)months, no severe complication such as neurovascular injury or graft reconstruction failure occured. Anterior drawer test and Lachman test were negative in all the patients. The grade of knee stability in sports(KSS)/cutting-pivoting ability (CPA)were A/A(37 cases), A/B(eight cases), B/A(five cases). The Lysholm score was 55(35, 61) before the surgery and increased to postoperative 92 (91, 94) in the post-operative 18 months, and the score of IKDC score was increased from 55 (34, 63) to 92 (91, 93) points in the post-operative 18 months. The Lysholm score and IKDC score of the patients 12 and 18 months after the surgery were better than those before the surgery(Lysholm score: Z=95.747, IKDC score: Z=95.358, both P<0.001), while the difference between 12 and 18 months after the surgery showed no statistically significant(Lysholm score: Z=1.485, adjusted P=0.472; IKDC score: Z=1.414, adjusted P=0.412). After 18 months of follow-up, five patients presented gradeⅠrelaxation (10%).

The surgical procedure for reverse suspension fixation in the treatment of knee ACL and ALS injury via non-shared tunnel may be more conducive to the recovery of the forward and rotation stabilization of knee, which has advantages of simple operation, independent adjustment of implant tension, safety and effectiveness.