Lee Yee Han Dave, Kuroda Ryosuke, Chan Kai Ming
Department of Orthopedic Surgery, Changi General Hospital, Singapore.
Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Asia Pac J Sports Med Arthrosc Rehabil Technol. 2015 Oct 14;2(4):122-128. doi: 10.1016/j.asmart.2015.08.003. eCollection 2015 Oct.
BACKGROUND/OBJECTIVE: The Magellan Society is composed of > 150 high-volume fellowship-trained sports surgeons from four continents. These surgeons represent their regional sports organisations in travelling fellowships and are considered to be opinion leaders in their respective organisations. Prior to the 2014 Magellan Meeting in Arima, Japan, a survey was conducted to understand how Magellan members perform anterior cruciate ligament (ACL) reconstruction. This study aims to better understand how ACL reconstruction is performed by sports surgeons worldwide and to determine differences in surgical practice.
A survey was conducted prior to the Magellan Meeting in Arima, Japan. Information on ACL graft of choice for primary surgery and revision surgery, preferred surgical techniques, and femoral and tibial graft fixation methods was collected. The incidence of meniscal tears and the management of injuries in ACL surgery were also studied. The results of the survey are discussed in this article.
A response rate of 51% (72 member respondents) was achieved for this survey. Hamstring autograft (58%) was the graft of choice for primary ACL reconstruction. The next most common autograft used was bone patella tendon bone autograft (28%). Allograft was the graft of choice in only 4% of respondents. The region of origin of surgeons and the age of surgeons were factors in the ACL graft of choice. Seventy-five percent of surgeons practised single-bundle ACL reconstructions only, 22% performed both single-bundle and double-bundle ACL reconstructions, and 3% performed double-bundle ACL reconstructions exclusively. Sixty-two percent of the respondents drilled femoral tunnels using the anteromedial portal technique. Meniscus repairs were performed in 25% of ACL reconstructions, on average.
Based on the survey, hamstring transportal anatomic single-bundle ACL reconstruction with meniscus preservation is the preferred ACL reconstruction technique of high-volume fellowship-trained sports surgeons.
背景/目的：麦哲伦协会由来自四大洲的150多名接受过高容量专科培训的运动外科医生组成。这些外科医生在交流访问奖学金项目中代表其所在地区的运动组织，被视为各自组织中的意见领袖。在2014年于日本有马举行的麦哲伦会议之前，开展了一项调查，以了解麦哲伦协会成员如何进行前交叉韧带（ACL）重建。本研究旨在更好地了解全球运动外科医生如何进行ACL重建，并确定手术操作上的差异。
在日本有马举行的麦哲伦会议之前进行了一项调查。收集了有关初次手术和翻修手术中首选的ACL移植物、首选的手术技术以及股骨和胫骨移植物固定方法的信息。还研究了半月板撕裂的发生率以及ACL手术中损伤的处理情况。本文讨论了调查结果。
本次调查的回复率为51%（72名成员回复）。腘绳肌自体移植物（58%）是初次ACL重建的首选移植物。接下来最常用的自体移植物是骨-髌腱-骨自体移植物（28%）。仅4%的受访者选择同种异体移植物。外科医生的原籍地区和年龄是选择ACL移植物的因素。75%的外科医生仅进行单束ACL重建，22%的医生同时进行单束和双束ACL重建，3%的医生仅进行双束ACL重建。62%的受访者使用前内侧入路技术钻股骨隧道。平均而言，25%的ACL重建手术进行了半月板修复。
基于本次调查，保留半月板的腘绳肌经隧道解剖单束ACL重建是接受过高容量专科培训的运动外科医生首选的ACL重建技术。
