Takahashi Tsuneari, Takeshita Katsushi
Department of Orthopaedic Surgery, Ishibashi General Hospital, Shimotsuke, Japan.
Department of Orthopaedic Surgery, School of Medicine, Jichi Medical University, Shimotsuke, Japan.
Arthrosc Tech. 2021 Oct 16;10(11):e2501-e2506. doi: 10.1016/j.eats.2021.07.033. eCollection 2021 Nov.
Although the transtibial (TT) technique for single-bundle (SB) arthroscopic anterior cruciate ligament (ACL) reconstruction has been widely used, surgeons often disadvantageously create the femoral bone tunnel at the arthroscopically noon position, which is alleged the "ACL isometric point," when the femoral bone tunnel could be created behind the resident's ridge with TT-SB ACL reconstruction by paying attention to the location of the tibial tunnel inlet and the angle of tibial tunnel. This alternative approach preserves ACL remnant tissue, which might contribute to better postoperative remodeling and regeneration of proprioceptive mechanoreceptors. This technique reduces surgical invasiveness and can enhance postoperative graft remodeling and proprioceptive recovery. To successfully use the devices required for this procedure, surgeons must understand the proper techniques. Hence, this technical note aims to demonstrate TT-SB ACL reconstruction with remnant tissue preservation.
尽管单束（SB）关节镜下前交叉韧带（ACL）重建的经胫骨（TT）技术已被广泛应用，但外科医生在进行关节镜手术时，常常在所谓的“ACL等长点”即关节镜下的中点位置创建股骨骨隧道，而实际上通过关注胫骨隧道入口位置和胫骨隧道角度，在TT-SB ACL重建中可以在髁间嵴后方创建股骨骨隧道。这种替代方法保留了ACL残余组织，这可能有助于术后更好地重塑和本体感觉机械感受器的再生。该技术减少了手术创伤，可增强术后移植物重塑和本体感觉恢复。为了成功使用该手术所需的器械，外科医生必须了解正确的技术。因此，本技术说明旨在演示保留残余组织的TT-SB ACL重建。
