Selim Naser M
Knee Surgery-Arthroscopy and Sports Injuries Unit, Department of Orthopedic, Mansoura University, Mansoura City, Egypt.
Arthrosc Tech. 2018 Apr 30;7(5):e557-e567. doi: 10.1016/j.eats.2018.01.010. eCollection 2018 May.
An untreated posterolateral corner (PLC) injury in patients with a torn anterior cruciate ligament (ACL) may be a leading cause of ACL reconstruction failure. Combined ACL and PLC reconstruction is discussed in few studies in the literature. Femoral tunnel intersection in combined reconstruction has been reported to be high. Short grafts may render combined reconstruction undoable. This Technical Note describes a technique that allows a combined ACL and PLC reconstruction. The ACL graft is a 4-stranded hamstring tendon graft from 1 limb. The PLC graft is a doubled semitendinosus tendon graft from the contralateral side. One femoral tunnel is used connecting the femoral attachment of the PLC on the lateral wall of the lateral femoral condyle to the anatomic femoral ACL footprint on the medial wall of the lateral femoral condyle. The PLC graft is suspended on the ACL graft to be anchored on the cortex of the lateral femoral condyle with added fixation by an interference screw (Arthrex, Naples, FL). The PLC graft limbs are used for open reconstruction of the fibular collateral ligament, popliteus tendon, and popliteofibular ligament. This Technical Note describes a technique of combined ACL and PLC reconstruction with hamstring tendon autografts through a single femoral tunnel using graft-to-graft suspension and fixation.
前交叉韧带（ACL）撕裂患者的后外侧角（PLC）损伤若未治疗，可能是ACL重建失败的主要原因。文献中很少有关于ACL和PLC联合重建的研究。据报道，联合重建时股骨隧道交叉发生率较高。短移植物可能使联合重建无法进行。本技术说明描述了一种可进行ACL和PLC联合重建的技术。ACL移植物是取自一侧肢体的4股绳肌腱移植物。PLC移植物是取自对侧的双股半腱肌腱移植物。使用一个股骨隧道，将PLC在股骨外侧髁外侧壁的股骨附着点与股骨外侧髁内侧壁的解剖学ACL足迹相连。PLC移植物悬吊于ACL移植物上，通过一枚挤压螺钉（Arthrex，那不勒斯，佛罗里达州）额外固定于股骨外侧髁皮质上。PLC移植物的肢体用于腓侧副韧带、腘肌腱和腘腓韧带的开放重建。本技术说明描述了一种通过单一股骨隧道，采用移植物间悬吊和固定的方法，使用自体绳肌腱进行ACL和PLC联合重建的技术。
