University of Michigan, Ann Arbor, MI, USA.
Am J Sports Med. 2011 Jun;39(6):1332-40. doi: 10.1177/0363546510387765. Epub 2010 Dec 20.
Injury to the posteromedial corner (PMC) of the knee differs anatomically and biomechanically from isolated injury to the medial collateral ligament. Newer anatomic and biomechanical studies are refining the field's understanding of the medial side of the knee, as well as its role in multiple ligament injuries. Valgus instability places additional strain on a reconstructed anterior or posterior cruciate ligament, which can contribute to late graft failure. Injuries to the PMC may not heal without surgical repair or reconstruction, particularly when part of a multiple-ligament injury. Identification of PMC injury before cruciate reconstruction is important so that appropriate repair or reconstruction of the PMC and medial collateral ligament can be undertaken at the same time. This article reviews the relevant literature on the PMC, discusses reasons for selective operative management, and illustrates reconstructive strategies for PMC injuries occurring as part of a medial-sided or multiligament injury to the knee.
膝关节后内侧角(PMC)损伤在解剖学和生物力学上与内侧副韧带的单独损伤不同。新的解剖学和生物力学研究正在深入了解膝关节的内侧结构及其在多韧带损伤中的作用。外翻不稳定会对重建的前交叉或后交叉韧带造成额外的压力,这可能导致晚期移植物失败。如果不进行手术修复或重建,PMC 损伤可能无法愈合,特别是当它是多韧带损伤的一部分时。在进行前交叉韧带重建之前确定 PMC 损伤非常重要,以便同时对 PMC 和内侧副韧带进行适当的修复或重建。本文回顾了 PMC 的相关文献,讨论了选择性手术治疗的原因,并举例说明了作为膝关节内侧或多韧带损伤一部分的 PMC 损伤的重建策略。