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三孔技术在解剖学单束或双束 ACL 重建中的应用进展。

Advances in the three-portal technique for anatomical single- or double-bundle ACL reconstruction.

机构信息

Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, 15213, USA.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2011 Aug;19(8):1239-42. doi: 10.1007/s00167-011-1426-z. Epub 2011 Feb 11.

DOI:10.1007/s00167-011-1426-z
PMID:21311862
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3136708/
Abstract

PURPOSE

To describe the "three-portal technique for anatomical ACL single- or double-bundle reconstruction" and the arthroscopic viewing improvement provided by this technique.

METHODS

A "high" anterolateral portal was placed 1 cm lateral to the patellar tendon and the most inferior portion of the portal at the level of the inferior pole of the patella. A "central" portal was placed using a spinal needle under arthroscopic visualization following the orientation of the previous ACL fibers. An accessory medial portal was also placed using a spinal needle respecting a 2-mm distance to the medial femoral condyle.

RESULTS

The "high" anterolateral portal permitted a broad and unobstructed view of the ACL tibial attachment. The "central" portal allowed a straightforward view of the ACL femoral remnant and bony landmarks in the intercondylar notch. The accessory medial portal enabled to reach the femoral native insertion site of the ACL.

CONCLUSION

The three-portal technique provides a proper view of the soft tissue remnants and bony landmarks facilitating an anatomical positioning of the graft.

摘要

目的

描述“三入口技术在解剖 ACL 单束或双束重建中的应用”以及该技术提供的关节镜观察改善效果。

方法

在前交叉韧带纤维的走向引导下，在髌腱外侧 1 厘米处和髌骨关节面下最下方位置建立一个“高位”前外侧入口（high anterolateral portal）。使用关节镜可视化技术，通过一根脊柱针在中心建立一个“中央”入口（central portal）。另外，通过一根脊柱针，距内侧股骨髁 2 毫米的位置建立一个辅助内侧入口（accessory medial portal）。

结果

“高位”前外侧入口（high anterolateral portal）可提供宽阔且无阻碍的 ACL 胫骨附着处视野。“中央”入口（central portal）可直视 ACL 股骨残端和髁间窝内的骨性标志。辅助内侧入口（accessory medial portal）可到达 ACL 的股骨原始插入点。

结论

三入口技术可提供软组织残端和骨性标志的适当视野，有助于移植的解剖定位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51fd/3136708/23f0748f258b/167_2011_1426_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51fd/3136708/2875929b7acd/167_2011_1426_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51fd/3136708/33346b80bf5e/167_2011_1426_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51fd/3136708/b3edd4bca948/167_2011_1426_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51fd/3136708/5e1d580e7b68/167_2011_1426_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51fd/3136708/b6226bd7c117/167_2011_1426_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51fd/3136708/23f0748f258b/167_2011_1426_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51fd/3136708/2875929b7acd/167_2011_1426_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51fd/3136708/33346b80bf5e/167_2011_1426_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51fd/3136708/b3edd4bca948/167_2011_1426_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51fd/3136708/5e1d580e7b68/167_2011_1426_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51fd/3136708/b6226bd7c117/167_2011_1426_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51fd/3136708/23f0748f258b/167_2011_1426_Fig6_HTML.jpg

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Surgical intra- and extra-articular anterior cruciate ligament reconstruction: a meta-analysis.
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Notchplasty alters knee biomechanics after anatomic ACL reconstruction.解剖重建 ACL 后， Notchplasty 改变了膝关节生物力学。
Knee Surg Sports Traumatol Arthrosc. 2020 Feb;28(2):614-621. doi: 10.1007/s00167-019-05766-y. Epub 2019 Nov 5.
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Over-the-top ACL reconstruction restores anterior and rotatory knee laxity in skeletally immature individuals and revision settings.过顶 ACL 重建可恢复骨骼未成熟个体和翻修环境中的前向和旋转膝关节松弛。
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Primary Anterior Cruciate Ligament Repair With Augmentation.前交叉韧带一期修复并加强术
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Revision anterior cruciate ligament surgery: experience from Pittsburgh.前交叉韧带手术翻修：来自匹兹堡的经验
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