Dong Jiangtao, Ji Gang, Zhang Yingze, Gao Shijun, Wang Fei, Chen Baicheng
Department of Joint Surgery, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.
Eur J Orthop Surg Traumatol. 2014 Aug;24(6):1025-9. doi: 10.1007/s00590-013-1265-3. Epub 2013 Jun 27.
We present a novel and simple method for single hamstring allograft MCL and PMC reconstruction, which can improve both joint valgus and external rotational stability and maximize utilization of allograft. All patients received arthroscopic evaluation through inferomedial and inferolateral knee incisions to ascertain whether there were intra-articular injuries. An 8-cm-length longitudinal incision was made from 1 cm above adductor tubercle to 5-cm proximal medial tibia joint line. The anterior tibia insertion was defined as 15 mm lateral from the medial tibia edge and 45 mm below the medial tibia joint line. The posterior tibia insertion was defined as 15 mm lateral from the medial tibia edge and 20 mm below the medial tibia joint line. A 5- or 6-mm reamer was used to drill the tibia tunnel along with guide pin, and a 6 or 7 mm drill was used to drill the femur tunnel to a depth of 25 or 30 mm until the proximal adductor tubercle. The allograft was harvested from tibia and placed into the tunnel and fixed with absorbable interference screw. All patients performed active rehabilitation exercises after the operation periodically.
我们提出了一种新颖且简单的单根腘绳肌同种异体移植物重建内侧副韧带(MCL)和后内侧角(PMC)的方法,该方法可改善关节外翻和外旋稳定性,并最大限度地利用同种异体移植物。所有患者均通过膝关节内下和外下切口接受关节镜评估,以确定是否存在关节内损伤。从内收肌结节上方1 cm至胫骨近端关节线内侧5 cm处做一个8 cm长的纵向切口。胫骨前插入点定义为距胫骨内侧边缘外侧15 mm且在胫骨内侧关节线下方45 mm处。胫骨后插入点定义为距胫骨内侧边缘外侧15 mm且在胫骨内侧关节线下方20 mm处。使用5或6 mm的扩孔钻沿导针钻胫骨隧道,使用6或7 mm的钻头钻股骨隧道至25或30 mm深度,直至近端内收肌结节。从胫骨获取同种异体移植物,放入隧道并用可吸收挤压螺钉固定。所有患者术后定期进行主动康复锻炼。