Reda Walid, Khedr Ahmed
Department of Orthopedics, Faculty of Medicine, Kasralainy Hospital, Cairo University, El Manial, Cairo, Egypt.
Arthrosc Tech. 2017 Aug 14;6(4):e1303-e1307. doi: 10.1016/j.eats.2017.05.007. eCollection 2017 Aug.
In most anterior cruciate ligament (ACL) tears, the tear is at the femoral side leaving a robust stump attached to the tibia. Stump-preserving ACL reconstruction carries the advantage of rapid reinnervation and revascularization of the graft. In this technique, the femoral tunnel is created after exposing the femoral footprint. The ACL tibial stump is split and the tip of the ACL tibial guide is introduced through this split to reach the center of the tibial footprint. The tibial tunnel is then created and the ACL stump is bored to allow the passage of the graft. After the passage of the graft inside the stump and femoral and tibial fixation, 1 or 2 sutures are used to suture the graft to the stump by a suture passing device (Expressew II; Depuy Mitek, Raynham, MA). This technique, in addition to preservation of the mechanoreceptors and vascular channels for revascularization and reinnervation of the graft, allows preservation of the shape and surface area of the wide tibial origin of the ACL.
在大多数前交叉韧带（ACL）撕裂中，撕裂发生在股骨侧，留下一个附着于胫骨的粗壮残端。保留残端的ACL重建具有移植物快速再神经支配和再血管化的优势。在这项技术中，在暴露股骨足迹后创建股骨隧道。将ACL胫骨残端劈开，通过该劈开处插入ACL胫骨导向器尖端，以到达胫骨足迹中心。然后创建胫骨隧道，并对ACL残端进行钻孔，以便移植物通过。在移植物穿过残端并进行股骨和胫骨固定后，使用1或2根缝线通过缝线传递装置（Expressew II；Depuy Mitek，Raynham，马萨诸塞州）将移植物缝合到残端。这项技术除了保留用于移植物再血管化和再神经支配的机械感受器和血管通道外，还能保留ACL宽阔胫骨起源的形状和表面积。
