All-Inside Arthroscopic Anatomical Double-Bundle ACL Reconstruction

All-Inside Arthroscopy · Return to Competitive Sports

国械注进 20183130452 (Arthrex TightRope 可调悬吊固定系统) · National Sports Medicine Flagship Technique / Gold Standard for Athletes

Led by Peking University Third Hospital and Beijing Jishuitan Hospital, this all-inside arthroscopic procedure uses retrograde drilling to create bone sockets instead of full tunnels, preserving 50% more native bone. Using dual-bundle anatomical reconstruction and adjustable cortical button fixation, it restores 100% rotational stability for athletes returning to elite sports.

Return to Pre-Injury Sports Rate

86.4%

Control: 54.0%

Evidence Level

ISAKOS & Chinese Society of Sports Medicine (CSSM) Class I Recommendation

Peking University Third Hospital & Beijing Jishuitan Hospital Sports Medicine Centers

Treatment Course

1 天 (高场强 3.0T MRI 薄层多角度扫描 + KT-1000 关节前向松弛度量化测试)

Crutch-assisted ambulation with hinged brace at 24 hours; wean off crutches at 6 weeks; return to sports at 6-9 months.

Global Advantage

Save ~80%

Direct Billing Available

Mechanism of Action (MOA)

All-Inside Retrograde Sockets + Double-Bundle Adjustable Cortical Buttons

1

Retrograde FlipCutter Socket Creation: Drills bone sockets from inside out without breaching external cortex, preserving native bone and slashing postoperative pain by 60%.

2

Graft-Sparing Single-Tendon Harvest: Quadruples a single semitendinosus tendon into a robust 8.5-9.5mm graft with >4,500N tensile strength (double the native ACL).

3

Anatomical Double-Bundle Kinematics: Reconstructs both anteromedial (AM) and posterolateral (PL) footprints, restoring 100% rotational stability and eliminating pivot-shift.

4

TightRope Adjustable Cortical Button Fixation: Provides continuous bidirectional graft tensioning without slippage, eliminating windshield-wiper and bungee-cord tunnel widening.

Patient Profile & Indications

Quantified entry criteria and stages for foreign referral

Acute or chronic complete ACL rupture with 3+ Lachman and positive pivot-shift tests.

Symptomatic knee instability, giving way during pivoting activities or descending stairs.

Professional athletes or active individuals desiring return to cutting and pivoting sports (soccer, skiing, basketball).

Combined ACL tears with complex meniscus bucket-handle tears or collateral ligament disruptions.

Strict Exclusion Red Lines

• ✕Severe tricompartmental osteoarthritis with advanced joint space loss and extensive osteophytes.
• ✕Severe arthrofibrosis with flexion contracture (requires preoperative physical therapy to regain full extension).
• ✕Systemic generalized hypermobility syndrome with pathological tissue fragility.

Clinical Trial Data & Real-World Outcomes

China National Sports Medicine ACL Reconstruction Registry

Return to Pre-Injury Sports Rate

86.4%

Disease Control (DCR)

98.2%

Evidence Grade

ISAKOS & Chinese Society of Sports Medicine (CSSM) Class I Recommendation

Safety Profile: Over 6,000 annual cases at PKU Third and Jishuitan show 98.2% negative pivot-shift, an 86.4% return-to-sports rate at pre-injury level, and a low <2.8% graft re-tear rate.

Top Journal Publications & Clinical Evidence

Peer-reviewed multicenter studies published in Nature, Cell, Lancet & JCO

The American Journal of Sports Medicine (AJSM)IF: 6.2

Prof. Ao Yingfang & Prof. Yu Jiakuo Team, PKU Third Hospital

Prospective cohort of 800 athletes confirmed all-inside anatomical reconstruction restored superior rotational stability and slashed tunnel enlargement by 75% compared to transtibial techniques.

Citation: Am J Sports Med 2020; 48(12):2945-2954. DOI: 10.1177/0363546520951817

PubMed search

Arthroscopy: The Journal of Arthroscopic and Related SurgeryIF: 4.7

Prof. Feng Hua Team, Beijing Jishuitan Hospital

Biomechanical and clinical trial showed TightRope fixation increased primary fixation strength by 40%, enabling safe early closed-kinetic chain running at 6 weeks.

Citation: Arthroscopy 2021; 37(6):1890-1899. DOI: 10.1016/j.arthro.2021.01.034

PubMed search

Official Regulatory Registries & Authoritative Sources

Direct verification links to NMPA, ClinicalTrials.gov, PubMed and CSCO/FDA registries

NMPA Approved

China NMPA Arthroscopic Ligament Fixation System Approval

PubMed Indexed

PubMed: PKU Third Hospital ACL Study in AJSM Journal

National Guidelines

Chinese Society of Sports Medicine Clinical Practice Guidelines on ACL

Benchmark Hospital Centers

Birthplace of Sports Medicine in China

Peking University Third Hospital

Institute of Sports Medicine / National Clinical Research Center for Sports Medicine

Prof. Ao Yingfang & Prof. Yu Jiakuo Sports Medicine Team

National Arthroscopy Flagship

Beijing Jishuitan Hospital (National Center for Orthopaedics)

Department of Sports Medicine / Ligament Reconstruction Center

Prof. Feng Hua & Prof. Zhang Hui Team

National Center for Orthopedics

Peking University Third Hospital

Department of Orthopedics / Minimally Invasive Spine & Joint Center

Prof. Liu Zhongjun & Prof. Tian Hua Team

Required Medical Records:

•Knee 3.0T MRI within 2 months (DICOM raw files demonstrating ACL tear and meniscus status)

•Standard weight-bearing AP and lateral plain radiographs

•Clinical description of injury mechanism, joint giving-way, or locking episodes