膝关节内侧韧带损伤的外科治疗：当前的适应症和技术

Surgical treatment of medial knee ligament injuries: current indications and techniques.

作者信息

Tandogan N Reha, Kayaalp Asim

机构信息

Çankaya Orthopedics, Ankara, Turkey.

出版信息

EFORT Open Rev. 2017 Mar 13;1(2):27-33. doi: 10.1302/2058-5241.1.000007. eCollection 2016 Feb.

The medial collateral ligament (MCL) and the posterior oblique ligament (POL) are the main static valgus restraints of the knee.Most isolated medial injuries can be treated with bracing and early knee motion.Combined MCL and ACL (anterior cruciate ligament) injuries can be managed with bracing of the knee followed by a delayed reconstruction of the ACL.Residual medial laxity may be addressed at the time of ACL surgery.Bony avulsions, incarceration of the distal MCL under the meniscus or over the pes anserinus tendons, open injuries, MCL tears combined with PCL or bi-cruciate injuries should be treated surgically.Chronic symptomatic medial instability can be managed with the recently described reconstruction techniques using free tendon grafts located at anatomical insertion sites. Cite this article: Tandogan NR, Kayaalp A. Surgical treatment of medial knee ligament injuries: Current indications and techniques. 2016;2:27-33. DOI: 10.1302/2058-5241.1.000007.

内侧副韧带（MCL）和后斜韧带（POL）是膝关节主要的静态外翻稳定结构。大多数单纯的内侧损伤可通过支具固定和早期膝关节活动来治疗。内侧副韧带和前交叉韧带（ACL）联合损伤可先通过膝关节支具固定，随后延期重建前交叉韧带。前交叉韧带手术时可处理残留的内侧松弛问题。骨撕脱、内侧副韧带远端嵌入半月板下方或鹅足肌腱上方、开放性损伤、内侧副韧带撕裂合并后交叉韧带或双交叉韧带损伤均应进行手术治疗。慢性症状性内侧不稳定可采用最近描述的重建技术，使用位于解剖学附着部位的游离肌腱移植物进行处理。引用本文：Tandogan NR, Kayaalp A. 膝关节内侧韧带损伤的手术治疗：当前适应证和技术。2016;2:27 - 33. DOI: 10.1302/2058 - 5241.1.000007。