Patel Karan A, Cabe Taylor, Drakos Mark
Department of Orthopedic Surgery, Foot and Ankle, Hospital for Special Surgery, New York, NY, USA.
Curr Rev Musculoskelet Med. 2020 Jun;13(3):289-297. doi: 10.1007/s12178-020-09623-1.
This paper seeks to review the current literature and trends regarding use of hamstring autograft for lateral ankle instability.
Reconstruction of the lateral ankle ligaments using hamstring autograft has been found to be an effective method to treat ankle instability in terms of patient-reported outcomes and objective measures. Biomechanically, reconstruction has been shown to be stronger (load to failure) when compared with the Broström procedure. Clinical studies have demonstrated non-inferiority when compared with the Broström procedure, with one synthetic reconstruction technique demonstrating superior outcomes. Reconstruction of the lateral ankle ligaments using hamstring autograft is especially useful in patients who are at high risk of failure (insufficient soft tissue available for repair, ligamentous laxity, previous failed ligament repair, ossicle > 1 cm, or in the heavier, high-demand athletes).
本文旨在回顾目前有关使用腘绳肌自体移植物治疗外侧踝关节不稳的文献及趋势。
就患者报告的结果和客观测量指标而言，使用腘绳肌自体移植物重建外侧踝关节韧带已被证明是治疗踝关节不稳的有效方法。在生物力学方面，与布罗斯特伦手术相比，重建术已显示出更强的强度（失效负荷）。临床研究表明，与布罗斯特伦手术相比，该手术并不逊色，有一种合成重建技术显示出更好的效果。对于失败风险高的患者（可用于修复的软组织不足、韧带松弛、先前韧带修复失败、小骨>1厘米，或体重较大、运动需求高的运动员），使用腘绳肌自体移植物重建外侧踝关节韧带尤其有用。
