Orthopaedic Unit and Kirk Kilgour Sports Injury Center, Sant'andrea University Hospital, La Sapienza University, Via di Grottarossa, 1037, 00189, Rome, Italy,
J Orthop Traumatol. 2014 Jun;15(2):75-9. doi: 10.1007/s10195-013-0254-y. Epub 2013 Aug 6.
Although ACL reconstructions provide satisfactory clinical results nowadays, regardless of the type of graft or the surgical technique used (out-in vs in-out or single- vs double-bundle), the residual rotatory instability which is often detected at clinical follow-ups is still a matter of concern among surgeons. In this paper we try to analyze all the aspects which might contribute to this phenomenon by summarizing the biomechanical functions of the two bundles of the ACL, and by evaluating all the other factors strictly related to the rotatory instability of a reconstructed knee, such as the anatomical positioning of the single- or double-bundle new ACL, or the importance of a valid lateral compartment (LCL, ALTFL). Clinical, biomechanical and cadaver studies are discussed in order to contribute to better understanding of the origin of post-operative residual rotatory instability.
尽管 ACL 重建术目前提供了令人满意的临床结果，但无论使用哪种移植物或手术技术（外-内 vs 内-外或单束-双束），在临床随访中经常检测到的残余旋转不稳定仍然是外科医生关注的问题。在本文中，我们试图通过总结 ACL 的两个束的生物力学功能，并通过评估与重建膝关节旋转不稳定密切相关的所有其他因素，例如单束或双束新 ACL 的解剖定位，或有效外侧间隔（LCL、ALTFL）的重要性，来分析导致这种现象的所有方面。讨论了临床、生物力学和尸体研究，以有助于更好地了解术后残余旋转不稳定的起源。
