Kang Seo Goo, Lee Yong Seuk
Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Knee Surg Relat Res. 2017 Mar 1;29(1):33-38. doi: 10.5792/ksrr.16.053.
The purpose of this study was to evaluate the efficacy of our technique that allows direct visualization of seating of suspensory devices in anterior cruciate ligament (ACL) reconstruction.
Three different suspensory devices (TightRope RT, RetroButton, and EndoButton) were used in ACL reconstruction using 3 different techniques (outside-in, anteromedial [AM] portal, and transtibial techniques). Positioning of a guiding material and seating pattern of the suspensory devices were evaluated according to the surgical technique and suspensory device used.
On the transtibial technique, 21 of total 26 cases (81%) of single bundle reconstructions and 22 of total 22 cases (100%) of double bundle reconstructions required superolateral capsulotomy where buttons were found in 21 of total 21 cases (100%) and 17 of 22 cases (77%), respectively. On the AM portal technique, all patients required capsulotomy and the button was found in only 18 of total 32 cases (56%) even after capsulotomy. On the outside-in technique, all patients required capsulotomy and the button was found in 86 of total 86 cases (100%).
Our technique for direct visualization of seating of the suspensory devices was more effective in outside-in and single bundle transtibial ACL reconstruction. However, it was less effective in double bundle transtibial and AM portal ACL reconstructions.
本研究旨在评估我们的技术在直接观察前交叉韧带(ACL)重建中悬吊装置就位情况的有效性。
在ACL重建中使用三种不同的悬吊装置(TightRope RT、RetroButton和EndoButton),采用三种不同的技术(由外向内、前内侧[AM]入路和经胫骨技术)。根据所使用的手术技术和悬吊装置,评估引导材料的定位和悬吊装置的就位模式。
在经胫骨技术中,26例单束重建中的21例(81%)和22例双束重建中的22例(100%)需要进行上外侧关节囊切开术,其中在21例单束重建中的21例(100%)和22例双束重建中的17例(77%)中发现了纽扣。在AM入路技术中,所有患者均需要进行关节囊切开术,即使在关节囊切开术后,在32例患者中也仅在18例(56%)中发现了纽扣。在由外向内技术中,所有患者均需要进行关节囊切开术,在86例患者中的86例(100%)中发现了纽扣。
我们用于直接观察悬吊装置就位情况的技术在由外向内和单束经胫骨ACL重建中更有效。然而,在双束经胫骨和AM入路ACL重建中效果较差。