Chiu Chih-Hao, Chi Jia-En, Huang Po-Hua, Chang Shih-Sheng, Hsu Kuo-Yao, Chao-Yu Chen Alvin, Chan Yi-Sheng
Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.
Arthrosc Tech. 2021 Mar 10;10(3):e789-e796. doi: 10.1016/j.eats.2020.10.069. eCollection 2021 Mar.
Anterior cruciate ligament reconstruction (ACLR) with additional procedures could be necessary for patients with increased preoperative pivot shift. Double-bundle (DB) ACLR provides more footprint coverage and recreates the 2 functional anteromedial (AM) and posterolateral (PL) bundles, which are believed to give better joint function and stability than single-bundle (SB) ACLR. Internal brace augmentation with suture tape is proposed along with tendon graft in ACLR to protect the newly reconstructed ligament during rehabilitation. Additional reconstruction with anterolateral ligament (ALL) during ACLR has shown significant reduction in the level of persistent pivot shift. In Technical Note we present a modified surgical technique of combined anatomic DB ACLR and ALLR with hamstring autograft and internal brace, using button suspensory fixation device and aperture screws. The objective of this technique is to decrease residual anterior and rotational instability after ACLR and ALLR.
对于术前轴移增加的患者，可能需要在前交叉韧带重建（ACLR）的基础上增加其他手术。双束（DB）ACLR提供了更大的足迹覆盖范围，并重建了两个功能性的前内侧（AM）束和后外侧（PL）束，据信这比单束（SB）ACLR能提供更好的关节功能和稳定性。在ACLR中，建议在肌腱移植的同时使用缝线带进行内部支撑增强，以在康复过程中保护新重建的韧带。在ACLR期间额外重建前外侧韧带（ALL）已显示持续性轴移水平显著降低。在技术说明中，我们介绍了一种改良的手术技术，即使用纽扣悬吊固定装置和孔径螺钉，采用自体腘绳肌腱移植和内部支撑，联合解剖学DB ACLR和ALLR。该技术的目的是减少ACLR和ALLR后残留的前向和旋转不稳定。
