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前交叉韧带双束结构的关节镜评估

Arthroscopic evaluation of the ACL double bundle structure.

作者信息

Steckel Hanno, Fu F H, Baums M H, Klinger H M

机构信息

Department of Orthopaedic Surgery, University of Göttingen, Robert-Koch-Strasse 40, 37073, Göttingen, Germany.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2009 Jul;17(7):782-5. doi: 10.1007/s00167-009-0783-3. Epub 2009 Mar 31.

DOI:10.1007/s00167-009-0783-3
PMID:19333575
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3085755/
Abstract

In order to describe the arthroscopic presence of the double bundle structure and to evaluate the value of different portals in knee arthroscopy, we assessed the AM and PL bundle anatomy. We prospectively examined the knees of 60 patients undergoing arthroscopic surgery for pathology unrelated to the ACL. Arthroscopy was performed in a two portal technique using an anterolateral (ALP) and an anteromedial (AMP) portal. With the arthroscope in the ALP, we could distinguish an AM and PL bundle in 28%. Switching the arthroscope to the AMP, differentiation of the bundles was possible in 67%. In all remaining cases visualization of the PL bundle was possible after retraction of the AM bundle. Use of AMP increased visualization of the PL bundle. It seems reasonable to perform arthroscopy for ACL reconstruction with the arthroscope in the AMP and to establish an additional medial working portal to increase the visualization of the femoral ACL insertion sites for optimal femoral tunnel placement.

摘要

为了描述双束结构在关节镜下的表现并评估不同入路在膝关节镜检查中的价值，我们对前内侧（AM）束和后外侧（PL）束的解剖结构进行了评估。我们前瞻性地检查了60例因与前交叉韧带（ACL）无关的病变而接受关节镜手术的患者的膝关节。关节镜检查采用双入路技术，使用前外侧（ALP）入路和前内侧（AMP）入路。当关节镜位于ALP入路时，我们在28%的病例中能够区分出AM束和PL束。将关节镜切换至AMP入路后，在67%的病例中能够区分出这两个束。在所有其余病例中，在牵拉AM束后可以看到PL束。使用AMP入路可增加PL束的可视性。在AMP入路使用关节镜进行ACL重建，并建立一个额外的内侧工作入路以增加股骨ACL附着点的可视性，从而实现最佳的股骨隧道定位，似乎是合理的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/230a/3085755/a80aee81744d/167_2009_783_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/230a/3085755/75746a067a3a/167_2009_783_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/230a/3085755/7b30e5a27f8d/167_2009_783_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/230a/3085755/75a28c3c78a6/167_2009_783_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/230a/3085755/d5f0e71fafa7/167_2009_783_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/230a/3085755/a80aee81744d/167_2009_783_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/230a/3085755/75746a067a3a/167_2009_783_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/230a/3085755/7b30e5a27f8d/167_2009_783_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/230a/3085755/75a28c3c78a6/167_2009_783_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/230a/3085755/d5f0e71fafa7/167_2009_783_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/230a/3085755/a80aee81744d/167_2009_783_Fig5_HTML.jpg

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本文引用的文献

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Arthroscopy. 2007 Mar;23(3):325.e1-5. doi: 10.1016/j.arthro.2006.07.030. Epub 2007 Jan 18.
2
Femoral attachment of the anterior cruciate ligament.前交叉韧带的股骨附着点。
Knee Surg Sports Traumatol Arthrosc. 2006 Mar;14(3):250-6. doi: 10.1007/s00167-005-0685-y. Epub 2005 Nov 10.
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Anatomy of the anterior cruciate ligament.前交叉韧带的解剖结构。
解剖双束 ACL 重建中，远前内侧入路钻孔与胫骨隧道钻孔致腓总神经损伤的风险比较。
Knee Surg Sports Traumatol Arthrosc. 2012 May;20(5):838-43. doi: 10.1007/s00167-011-1632-8. Epub 2011 Aug 10.
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Evaluation of the tunnel placement in the anatomical double-bundle ACL reconstruction: a cadaver study.解剖双束 ACL 重建中隧道位置的评估：尸体研究。
Knee Surg Sports Traumatol Arthrosc. 2010 Sep;18(9):1226-31. doi: 10.1007/s00167-010-1128-y.
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Placement of femoral tunnel between the AM and PL bundles using a transtibial technique in single-bundle ACL reconstruction.经胫骨技术在单束 ACL 重建中于 AM 和 PL 束之间放置股骨隧道。
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