Ospedale Mauriziano Umberto I Torino, SCDU Ortopedia e Traumatologia, Università degli Studi di Torino, Largo Turati 62, 10128, Torino, Italy,
Curr Rev Musculoskelet Med. 2011 Jun;4(2):52-6. doi: 10.1007/s12178-011-9078-7.
The anterior cruciate ligament reconstruction is a common procedure that improves stability and function of the knee. The surgical technique continues to evolve and many issues are still under debate. These mainly include: (1) graft selection (patellar tendon, hamstring, quadriceps tendon, or allografts), (2) surgical technique (double versus single bundle), and (3) femoral tunnel drilling. Currently, the most controversial one is the femoral tunnel drilling (transtibial vs. anteromedial portal drilling). Common opinion is that drilling the femoral tunnel through the anteromedial (AM) allows a more anatomic placement of the graft and a better rotational stability; therefore, this technique is gaining in popularity compared with the transtibial drilling despite a greater difficulty and the risk of medial condyle damage, tunnel back wall blowout, and inadequate socket length. The aim of this article is to describe the surgical technique of the anterior cruciate ligament reconstruction (single and double bundle), drilling the femoral tunnel through the AM portal.
前交叉韧带重建是一种常见的手术，可改善膝关节的稳定性和功能。手术技术不断发展，许多问题仍存在争议。这些主要包括：（1）移植物选择（髌腱、腘绳肌肌腱、股四头肌肌腱或同种异体移植物），（2）手术技术（双束与单束），以及（3）股骨隧道钻孔。目前，最具争议的是股骨隧道钻孔（经胫骨 vs. 前内侧入路钻孔）。普遍认为，经前内侧（AM）入路钻孔可使移植物更符合解剖学位置，并获得更好的旋转稳定性；因此，与经胫骨钻孔相比，这种技术越来越受欢迎，尽管其难度更大，且存在内侧髁损伤、隧道后壁爆裂和插座长度不足的风险。本文旨在描述前交叉韧带重建（单束和双束）的手术技术，即经 AM 入路钻孔。
