Musahl Volker, Getgood Alan, Neyret Philippe, Claes Steven, Burnham Jeremy M, Batailler Cecile, Sonnery-Cottet Bertrand, Williams Andy, Amis Andrew, Zaffagnini Stefano, Karlsson Jón
UPMC Center for Sports Medicine, 3200 S Water St, Pittsburgh, PA, 15203, USA.
Fowler Kennedy Sport Medicine Clinic, London, ON, Canada.
Knee Surg Sports Traumatol Arthrosc. 2017 Apr;25(4):997-1008. doi: 10.1007/s00167-017-4436-7. Epub 2017 Mar 12.
Persistent rotatory knee laxity is increasingly recognized as a common finding after anterior cruciate ligament (ACL) reconstruction. While the reasons behind rotator knee laxity are multifactorial, the impact of the anterolateral knee structures is significant. As such, substantial focus has been directed toward better understanding these structures, including their anatomy, biomechanics, in vivo function, injury patterns, and the ideal procedures with which to address any rotatory knee laxity that results from damage to these structures. However, the complexity of lateral knee anatomy, varying dissection techniques, differing specimen preparation methods, inconsistent sectioning techniques in biomechanical studies, and confusing terminology have led to discrepancies in published studies on the topic. Furthermore, anatomical and functional descriptions have varied widely. As such, we have assembled a panel of expert surgeons and scientists to discuss the roles of the anterolateral structures in rotatory knee laxity, the healing potential of these structures, the most appropriate procedures to address rotatory knee laxity, and the indications for these procedures. In this round table discussion, KSSTA Editor-in-Chief Professor Jón Karlsson poses a variety of relevant and timely questions, and experts from around the world provide answers based on their personal experiences, scientific study, and interpretations of the literature. Level of evidence V.
持续性旋转性膝关节松弛越来越被认为是前交叉韧带(ACL)重建术后的常见表现。虽然旋转性膝关节松弛背后的原因是多因素的,但膝关节前外侧结构的影响很大。因此,大量的研究重点都放在了更好地了解这些结构上,包括它们的解剖结构、生物力学、体内功能、损伤模式,以及处理因这些结构受损导致的旋转性膝关节松弛的理想手术方法。然而,膝关节外侧解剖结构的复杂性、不同的解剖技术、不同的标本制备方法、生物力学研究中不一致的切片技术以及令人困惑的术语,导致了关于该主题的已发表研究存在差异。此外,解剖学和功能描述也有很大差异。因此,我们召集了一组专家外科医生和科学家,来讨论前外侧结构在旋转性膝关节松弛中的作用、这些结构的愈合潜力、处理旋转性膝关节松弛的最合适手术方法以及这些手术的适应症。在这次圆桌讨论中,KSSTA主编约恩·卡尔松教授提出了各种相关且及时的问题,来自世界各地的专家根据他们的个人经验、科学研究以及对文献的解读给出了答案。证据等级为V级。