Objective: To review the research progress regarding the over-the-top technique for anterior cruciate ligament (ACL) reconstruction.
Methods: The relevant literature on ACL reconstruction using the over-the-top technique was analyzed for its evolution, clinical application, advantages, and limitations.
Results: Over-the-top technique for ACL reconstruction is a combined intra- and extra-articular technique. Because it avoids drilling the femoral tunnel, its advantages are mainly highlighted in the protection of the femur. Therefore, it is widely used in children and adolescents with epiphyseal occlusion and in patients with revision reconstruction. In addition, significant improvements in postoperative joint stability, functional scores, and return to exercise rates are found in long-term follow-up studies of patients with primary ACL reconstruction and combined anterolateral tenodesis. However, the technique also has some limitations, such as poor stability of knee flexion after operation, high requirement for graft length, and easy impact of graft in the intercondylar fossa.
Conclusion: The current research results show the effectiveness and safety of the over-the-top technique for primary and revision ACL reconstruction, with the advantages of wide application, simple operation, and quick recovery; however, more researches are needed to further optimize the selection of grafts and femoral condyle management problems, and to clarify the long-term effectiveness.
目的: 对越顶技术重建前交叉韧带（anterior cruciate ligament，ACL）的研究进展进行综述。.
方法: 广泛查阅有关使用越顶技术重建ACL的文献，分析该技术的发展过程、临床应用、优势以及局限性。.
结果: 越顶技术重建ACL是一种关节内外联合技术，由于避免了钻取股骨隧道，在骨骺未闭合的儿童和青少年患者及翻修重建患者中广泛应用。此外，在初次ACL重建和联合前外侧肌腱固定术患者的长期随访研究中发现，患者术后关节稳定性、功能评分和重返运动率均得到显著改善。然而该技术也存在局限性，如术后膝关节屈曲状态时稳定性差，对移植物长度要求高，以及移植物易在髁间窝内产生撞击等。.
结论: 目前研究证实了越顶技术用于初次及翻修ACL重建的有效性和安全性，具有适用范围广、手术操作简单以及患者康复快等优势；但还需要更多研究进一步优化移植物选择及股骨髁的处理问题，并明确远期疗效。.
Keywords: Anterior cruciate ligament; over-the-top technique; reconstruction.