Frings Jannik, Kolb Jan P, Drenck Tobias C, Krause Matthias, Alm Lena, Akoto Ralph, Frosch Karl-Heinz
Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Trauma and Reconstructive Surgery, Asklepios Clinic St. Georg, Hamburg, Germany.
Arthrosc Tech. 2019 Jan 21;8(2):e153-e161. doi: 10.1016/j.eats.2018.10.010. eCollection 2019 Feb.
Injuries of the posterolateral corner (PLC) of the knee lead to chronic lateral and external rotational instability. Successful treatment of PLC injuries requires an understanding of the complex anatomy and biomechanics of the PLC. Several open PLC reconstruction techniques have been published. It is understood that anatomic reconstruction is superior to extra-anatomic techniques, leading to better clinical results. An open, anatomic, fibula-based technique for reconstruction to address lateral and rotational instability has been described. However, when an open technique is used, surgeon and patient are faced with disadvantages, such as soft tissue damage or exposure of vulnerable structures. Few arthroscopic techniques for tibia- or fibula-based reconstruction of rotational posterolateral instability have been described. A complete arthroscopic stabilization of the combined lateral and posterolateral rotational instability of the knee has not yet been described. We therefore present the first all-arthroscopic technique for complete PLC reconstruction, based on an open technique described previously. All relevant landmarks of the PLC can be arthroscopically visualized in detail, allowing safe and effective treatment of PLC injuries.
膝关节后外侧角(PLC)损伤会导致慢性外侧及外旋不稳定。成功治疗PLC损伤需要了解PLC复杂的解剖结构和生物力学。已经发表了几种开放性PLC重建技术。据了解,解剖重建优于非解剖技术,可带来更好的临床效果。已经描述了一种基于开放、解剖、腓骨的重建技术来解决外侧和旋转不稳定问题。然而,当使用开放技术时,外科医生和患者会面临一些缺点,比如软组织损伤或暴露脆弱结构。很少有关于基于胫骨或腓骨的旋转后外侧不稳定关节镜重建技术的描述。尚未有关于膝关节外侧和后外侧旋转不稳定联合损伤的完全关节镜稳定技术的描述。因此,我们基于之前描述的开放技术,提出了第一种用于完整PLC重建的全关节镜技术。PLC的所有相关标志点都可以在关节镜下详细可视化,从而能够安全有效地治疗PLC损伤。