2022, Vol. 26 ›› Issue (8): 1293-1298

RESULTS AND CONCLUSION: Studies have shown that the femoral and humeral entheses of the ACL are direct entheses, transitioning from fibrocartilage to osseous tissue. The fibrocartilage layer is thicker on the femoral side than on the tibial side and larger on the anterior medial bundle, which is related to the mechanical stimulation during development. In addition, there is a certain law for the transition of molecules and proteins from tendonous structure to osseous tissue, which is mainly present with type I collagen in the tendon, type II collagen at the attachment point, and then type I collagen in bone tissue. Currently, tendon-to-bone healing is mainly enhanced by biological factors such as platelet-rich plasma. The surgical method and the graft fixation method have been developed to promote tendon-to-bone healing by modifying the mechanical environment or using tissue engineering. However, the results are still somewhat different. By studying the basic level of native ACL enthesis, the surgical reconstruction method can be improved accordingly in order to restore its original healing and mechanical function. In clinical research, studies on the use of biological factors, surgical improvements, and the introduction of new materials have gradually increased, but there is still a lack of relatively systematic verification. In the future, it should be further verified from molecular, protein, cell, and animal experiments to clinical randomized controlled trials.

Key words:knee joint, anterior cruciate ligament, tendon-to-bone enthesis, tendon-to-bone healing, ligament reconstruction