Pache Santiago, Sienra Martín, Larroque Diego, Talamás Rodrigo, Aman Zachary S, Vilensky Eduardo, LaPrade Robert F
Department of Orthopedic Surgery, Centro Asistencial del Sindicato Médico del Uruguay (CASMU), Montevideo, Uruguay.
Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.
Arthrosc Tech. 2021 Jan 16;10(2):e487-e497. doi: 10.1016/j.eats.2020.10.033. eCollection 2021 Feb.
An anatomically based posterolateral corner (PLC) reconstruction has emerged as a viable and clinically effective surgical technique for midsubstance ligamentous injuries in both the acute and chronic settings. There are several surgical techniques for PLC reconstruction; however, the classic anatomic reconstruction technique (LaPrade technique) is now considered the gold standard and was originally described using an Achilles tendon allograft. In this article, we describe a modified LaPrade autograft technique, in which the same tunnel position, graft passage, and fixation are used to reproduce the 3 primary stabilizers of the PLC. Instead of allografts, hamstring autografts are used while tunnel diameters and fixation devices are adapted to them. With the use of autograft tendons, difficulties related to graft length or asymmetry are encountered. We consider this technique a good alternative for an anatomically based PLC reconstruction, especially given the lower availability and higher cost of allograft tissues in several countries.
基于解剖学的后外侧角（PLC）重建已成为一种可行且临床有效的手术技术，可用于急性和慢性环境下的韧带中部损伤。PLC重建有多种手术技术；然而，经典的解剖重建技术（LaPrade技术）现在被认为是金标准，最初是使用跟腱同种异体移植物进行描述的。在本文中，我们描述了一种改良的LaPrade自体移植物技术，其中使用相同的隧道位置、移植物通道和固定方法来重现PLC的3个主要稳定器。使用腘绳肌自体移植物代替同种异体移植物，同时隧道直径和固定装置也与之适配。使用自体移植肌腱时，会遇到与移植物长度或不对称性相关的困难。我们认为这种技术是基于解剖学的PLC重建的一个很好的替代方案，特别是考虑到在一些国家同种异体移植组织的可用性较低且成本较高。
