Anatomic reconstruction of the anteromedial and posterolateral bundles of the anterior cruciate ligament using hamstring tendon grafts
Anatomic reconstruction of the anteromedial and posterolateral bundles of the anterior cruciate ligament using hamstring tendon grafts
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DOI：
10.1016/j.arthro.2004.08.010
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发表时间：
2004-12-01
影响因子：
4.7
通讯作者：
Minami, A
中科院分区：
文献类型：
--
作者：
Yasuda, K;Kondo, E;Minami, A
目的：目的：研究和评价前交叉韧带（ACL）后外侧束和前内侧束的解剖重建术式。研究类型：解剖研究和病例系列。方法：在5具尸体膝关节标本上，对前交叉韧带前内侧束和后外侧束的股骨附着点进行解剖学分析。另取3例尸体膝关节，采用经胫骨技术对后外侧和前内侧束进行解剖重建，观察隧道定位和移植物在膝关节活动范围内的功能。在此解剖学研究的基础上，提出了一种利用自体腘绳肌肌腱重建前内侧束和后外侧束的解剖学方法。该手术在57例ACL缺陷膝关节的连续患者中进行。患者至少随访24个月。结果如下：我们开发了后外侧束和前内侧束的关节镜辅助解剖重建手术，包括为后外侧束创建胫骨和股骨隧道的新方法。为了观察后外侧束的股骨附着，内侧髌下入路比外侧入路更有用。在临床结果中，前松弛度的侧-侧差异平均为1.0 mm，标准差为0.9。结论：自体腘绳肌肌腱解剖重建前内侧束和后外侧束在治疗ACL缺陷的膝关节中具有临床实用性。证据等级：IV级。
Purpose: To develop and evaluate an anatomic reconstruction procedure of the posterolateral and anteromedial bundles of the anterior cruciate ligament (ACL). Type of Study: Anatomic study and case series. Methods: The femoral attachment of the anteromedial and posterolateral bundles of the ACL was anatomically analyzed with 5 cadaveric knees. Using another 3 cadaveric knees, anatomic reconstruction of the posterolateral and anteromedial bundles was performed with the transtibial technique, and tunnel positioning and graft function in a range of knee motion was observed. Based on this anatomic study, an anatomic reconstruction procedure of the anteromedial and posterolateral bundles was developed using hamstring tendon autografts. This procedure was carried out in 57 consecutive patients with an ACL-deficient knee. The patients were followed-up for a minimum of 24 months. Results: We developed the arthroscopically assisted anatomic reconstruction procedure of the posterolateral and anteromedial bundles, involving a new method of creating the tibial and femoral tunnels for the posterolateral bundle. To visualize the femoral attachment of the posterolateral bundle, the medial infrapatellar portal was more useful than the lateral portal. In clinical results, the side-to-side difference of anterior laxity averaged 1.0 mm with a standard deviation of 0.9. Conclusions: The anatomic reconstruction of the anteromedial and posterolateral bundles using hamstring tendon autografts is clinically practical in the treatment for the ACL-deficient knee. Level of Evidence: Level IV.