Jonkergouw Anne, van der List Jelle P, DiFelice Gregory S
Orthopaedic Trauma Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY, U.S.A.
Arthrosc Tech. 2018 Jul 16;7(8):e839-e843. doi: 10.1016/j.eats.2018.04.006. eCollection 2018 Aug.
Knee dislocations often result in a severe multiligament injured knee (MLIK) with complex instability. Multiligament reconstruction can successfully restore knee stability and is commonly recommended, although surgical morbidity is induced by graft harvesting and tunnel drilling, and convergence of multiple tunnels can complicate the surgery. Therefore, as an alternative, primary repair of knee ligaments is currently reconsidered. The main advantages of primary repair consist of tissue preservation and decrease of surgical morbidity, which might improve knee functionality. Techniques in which avulsed ligaments are reapproximated to their anatomic origin have resulted in good clinical outcomes in selected patients over the past decade. More recently, repaired ligaments have been augmented with suture tape, to protect them from excessive stretch, which can improve healing and allows early rehabilitation. The surgical technique of primary repair in the multiligament injured knee has not yet been described. The purpose of this Technical Note is to explain suture augmented primary repair in KDIII-M injury, including the anterior cruciate ligament, posterior cruciate ligament, and medial collateral ligament.
膝关节脱位常导致严重的多韧带损伤膝关节(MLIK)并伴有复杂的不稳定。多韧带重建可成功恢复膝关节稳定性,是普遍推荐的方法,尽管取腱和钻隧道会引发手术并发症,且多个隧道的汇聚可能使手术复杂化。因此,作为一种替代方法,目前正在重新考虑对膝关节韧带进行一期修复。一期修复的主要优点包括保留组织和降低手术并发症,这可能改善膝关节功能。在过去十年中,将撕脱的韧带重新近似其解剖学起点的技术在部分患者中取得了良好的临床效果。最近,已用缝合带加强修复后的韧带,以保护其免受过度拉伸,这可促进愈合并允许早期康复。多韧带损伤膝关节的一期修复手术技术尚未见报道。本技术说明的目的是解释KDIII - M损伤(包括前交叉韧带、后交叉韧带和内侧副韧带)的缝合加强一期修复。