Borton Zakk M, Yasen Sam K, Britton Edward M, Heaton Samuel R, Palmer Harry C, Wilson Adrian J
Basingstoke and North Hampshire Hospital, Basingstoke, United Kingdom.
York Teaching Hospital, York, United Kingdom.
Arthrosc Tech. 2017 Mar 20;6(2):e331-e339. doi: 10.1016/j.eats.2016.10.007. eCollection 2017 Apr.
The anterior cruciate ligament (ACL) is the most commonly injured knee ligament, particularly among adolescents and young adults. Unrecognized posterolateral laxity is understood as a major cause of ACL reconstruction failure, and concomitant injury to the posterolateral corner (PLC) is prevalent and underdetected. We advocate screening all ACL-deficient knees for PLC injury and present a technique combining minimally invasive PLC reconstruction with anatomic all-inside ACL reconstruction. The combined procedure uses only the ipsilateral hamstring tendons representing a major surgical advantage over traditional management approaches. The semitendinosus is quadrupled and attached to 2 adjustable suspensory cortical fixation devices to form the ACL graft. The gracilis tendon is looped through the fibula head and secured in a single femoral tunnel for the PLC reconstruction via 2 minimally invasive incisions. The use of a single femoral PLC tunnel combined with a single femoral ACL socket minimizes the risk of tunnel convergence.
前交叉韧带（ACL）是最常受伤的膝关节韧带，在青少年和年轻成年人中尤为常见。未被识别的后外侧松弛被认为是ACL重建失败的主要原因，而后外侧角（PLC）的合并损伤很普遍且未被充分检测到。我们主张对所有ACL缺失的膝关节进行PLC损伤筛查，并提出一种将微创PLC重建与解剖学全内置ACL重建相结合的技术。该联合手术仅使用同侧腘绳肌腱，这是相对于传统治疗方法的一个主要手术优势。半腱肌被四股化并附着于2个可调节的悬吊皮质固定装置以形成ACL移植物。股薄肌腱绕过腓骨头，并通过2个微创切口固定在单个股骨隧道中用于PLC重建。使用单个股骨PLC隧道与单个股骨ACL骨道相结合可将隧道汇聚的风险降至最低。
