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膝关节后外侧角解剖重建

Anatomic posterolateral corner knee reconstruction.

作者信息

Arciero Robert A

机构信息

Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut, USA.

出版信息

Arthroscopy. 2005 Sep;21(9):1147. doi: 10.1016/j.arthro.2005.06.008.

Abstract

Injuries to the lateral collateral ligament and posterolateral corner of the knee, particularly when combined with anterior cruciate or posterior cruciate ligament injuries, can result in profound symptomatic knee instability. Although many surgical improvements have been made in reconstruction of anterior and posterior cruciate ligament injuries, reconstruction of the posterolateral corner has had less predictable results, with residual pathologic laxity especially in the chronic situation. This has stimulated many surgeons to recommend acute repair of posterolateral knee injuries. This article describes a more anatomic reconstruction of the posterolateral corner for chronic instability, recreating the lateral collateral ligament and popliteofibular ligament using either autogenous or allograft soft tissue and an interference screw technique. In a small clinical series, this has proven to restore varus rotation and external rotation patholaxities with a high degree of predictability.

摘要

膝关节外侧副韧带和后外侧角损伤,尤其是合并前交叉韧带或后交叉韧带损伤时,可导致严重的膝关节症状性不稳定。尽管在前交叉韧带和后交叉韧带损伤的重建方面已经取得了许多手术改进,但后外侧角的重建效果却难以预测,尤其是在慢性损伤情况下会残留病理性松弛。这促使许多外科医生建议对膝关节后外侧损伤进行急性修复。本文描述了一种针对慢性不稳定的后外侧角更符合解剖结构的重建方法,使用自体或异体软组织和干涉螺钉技术重建外侧副韧带和腘腓韧带。在一个小型临床系列中,已证明这种方法能够高度可预测地恢复内翻旋转和外旋松弛。

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