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使用带袢C形胫骨骨隧道的带状移植物进行前交叉韧带重建

Anterior Cruciate Ligament Reconstruction Using a Ribbon-Like Graft With a C-Shaped Tibial Bone Tunnel.

作者信息

Fink Christian, Smigielski Robert, Siebold Rainer, Abermann Elisabeth, Herbort Mirco

机构信息

Gelenkpunkt-Sports and Joint Surgery, Innsbruck, Austria.

Research Unit for Orthopaedic Sports Medicine and Injury Prevention, UMIT, Hall, Austria.

出版信息

Arthrosc Tech. 2020 Jan 22;9(2):e247-e262. doi: 10.1016/j.eats.2019.10.005. eCollection 2020 Feb.

DOI:10.1016/j.eats.2019.10.005
PMID:32099779
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7029192/
Abstract

According to recent anatomic studies, the anterior cruciate ligament (ACL) appears to be a flat, "ribbon-like" structure, with a thin, oval-shaped insertion on the femur and a C-shaped tibial insertion. According to this anatomy, we describe an ACL-reconstruction technique that aims to approximate this natural anatomy. The basic principle of this technique is not to use conventional round tunnels but create tunnel shapes that resemble more closely the original ACL insertion sites. Using either a rectangular quadriceps tendon graft or a "flat" hamstring graft may not only provide a biomechanical advantage with increased rotational stability but also improve bone-tendon healing due to increased bone-tendon contact and decreased diffusion length. Creating a C-shaped tibial tunnel also avoids laceration of the anterior horn of the lateral meniscus, which is frequently harmed during conventional tibial tunnel drilling.

摘要

根据最近的解剖学研究，前交叉韧带（ACL）似乎是一个扁平的“带状”结构，在股骨上有一个薄的椭圆形附着点，在胫骨上有一个C形附着点。基于这种解剖结构，我们描述了一种ACL重建技术，旨在接近这种自然解剖结构。该技术的基本原则不是使用传统的圆形隧道，而是创建更接近原始ACL附着部位的隧道形状。使用矩形股四头肌腱移植物或“扁平”腘绳肌腱移植物不仅可以提供生物力学优势，增加旋转稳定性，还可以由于增加骨-肌腱接触和缩短扩散长度而改善骨-肌腱愈合。创建C形胫骨隧道还可以避免外侧半月板前角的撕裂，而在传统的胫骨隧道钻孔过程中，外侧半月板前角经常受到损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/fe66e3b8ce8f/gr15.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/d80b24e15b7b/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/411e079836df/gr8.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/dbee13109b9f/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/d4e98365e7e7/gr11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/c134b40671e7/gr12.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/cc8863001bf7/gr13.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/5c04d81b4664/gr14.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/fe66e3b8ce8f/gr15.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/7adf221d00a1/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/fe40679941e7/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/d96e8a831608/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/0c1ffc5c8bdf/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/812699460d9e/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/922346226c4d/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/d80b24e15b7b/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/411e079836df/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/9b3c52baf99b/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/dbee13109b9f/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/d4e98365e7e7/gr11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/c134b40671e7/gr12.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/cc8863001bf7/gr13.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/5c04d81b4664/gr14.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fb/7029192/fe66e3b8ce8f/gr15.jpg

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