Bonanzinga T, Signorelli C, Grassi A, Lopomo N, Jain M, Mosca M, Iacono F, Marcacci M, Zaffagnini S
Humanitas Clinical and Research Center, Milano, MI, Italy.
Dipartimento Scienze Biomediche e Neuromotorie, Università di Bologna, DIBINEM, Bologna, BO, Italy.
Knee Surg Sports Traumatol Arthrosc. 2017 Apr;25(4):1062-1067. doi: 10.1007/s00167-017-4496-8. Epub 2017 Mar 9.
To quantify the influence of Single-Bundle with Lateral Plasty and Double-Bundle reconstruction on static and dynamic laxity in combined ACL- and ALL-deficient knees.
The study included 10 fresh-frozen human knees. The joints were analyzed in the following conditions: ACL + ALL resection, Single-Bundle with Lateral Plasty (SBLP) reconstruction, Double-Bundle (DB) reconstruction. Testing parameters were: anterior displacement at 30° and 90° of flexion (AP30, AP90) applying a manual maximum load; internal rotation at 30° and 90° of flexion (INT30, INT90) applying a 5 Nm torque and acceleration and internal rotation Pivot-Shift (PS) test. Kinematics was acquired by a navigation system. Paired Student's t test was conducted to assess statistical difference (P < 0.05).
At both 30° and 90° of knee flexion, both SBLP and DB surgical techniques showed a significant reduction (P < 0.01) of anterior-posterior tibial displacement compared to the resection of ACL + ALL. At 30° on knee flexion it is the SBLP that allows the greatest reduction of internal rotational laxity when compared to DB reconstruction. Concerning the PS test, only SBPL procedure had a significant laxity decrease considering the acceleration reached by the joint when compared with the ACL + ALL state (P < 0.01).
Clinical relevance of this study is that the internal rotation and PS test were more efficiently controlled by the SBLP technique than by the DB one at both 30° and 90° of flexion in case of ACL + ALL lesions.
量化单束联合外侧成形术和双束重建对前交叉韧带（ACL）和前外侧韧带（ALL）联合损伤膝关节的静态和动态松弛度的影响。
本研究纳入10例新鲜冷冻人体膝关节。在以下条件下对关节进行分析：ACL + ALL切除、单束联合外侧成形术（SBLP）重建、双束（DB）重建。测试参数包括：在30°和90°屈曲时施加手动最大负荷下的胫骨前移（AP30、AP90）；在30°和90°屈曲时施加5 N·m扭矩下的内旋（INT30、INT90）以及加速和内旋轴移（PS）试验。通过导航系统获取运动学数据。采用配对学生t检验评估统计学差异（P < 0.05）。
在膝关节屈曲30°和90°时，与ACL + ALL切除相比，SBLP和DB手术技术均显示胫前后位移显著减少（P < 0.01）。在膝关节屈曲30°时，与DB重建相比，SBLP能最大程度减少内旋松弛度。关于PS试验，与ACL + ALL状态相比，仅SBLP手术在关节达到的加速度方面有显著的松弛度降低（P < 0.01）。
本研究的临床意义在于，在ACL + ALL损伤的情况下，在屈曲30°和90°时，SBLP技术比DB技术能更有效地控制内旋和PS试验。
