Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea.
Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Korea.
Medicina (Kaunas). 2022 Jun 10;58(6):786. doi: 10.3390/medicina58060786.
Despite remarkable advances in the clinical outcomes after anterior cruciate ligament reconstructions (ACLRs), residual rotational instability of the knee joint remains a major concern. Since the anterolateral ligament (ALL) on the knee joint has been "rediscovered", the role of anterolateral structures, including ALL and deep iliotibial band, as secondary stabilizers of anterolateral rotatory instability has gained interest. This interest has led to the resurgence of anterolateral procedures combined with ACLRs to restore rotational stability in patients with anterior cruciate ligament (ACL) deficiencies. However, the difference in concepts between anterolateral ligament reconstructions (ALLRs) as anatomical reconstruction and lateral extra-articular tenodesis (LETs) as non-anatomical reinforcement has been conflicting in present literature. This study aimed to review the anatomy and biomechanics of anterolateral structures, surgical techniques, and the clinical outcomes of anterolateral procedures, including LET and ALLR, in patients with ACL deficiencies.
尽管前交叉韧带重建（ACLR）后的临床结果有了显著的进步，但膝关节的残余旋转不稳定仍然是一个主要关注点。自从膝关节的前外侧韧带（ALL）被“重新发现”以来，前外侧结构（包括 ALL 和深层阔筋膜张肌带）作为前外侧旋转不稳定的次要稳定器的作用引起了人们的兴趣。这种兴趣导致了前外侧手术与 ACLR 的结合，以恢复 ACL 缺陷患者的旋转稳定性。然而，目前文献中关于前外侧韧带重建（ALLR）作为解剖重建和外侧关节外腱固定术（LET）作为非解剖增强的概念差异存在冲突。本研究旨在回顾前外侧结构的解剖和生物力学、手术技术以及包括 LET 和 ALLR 在内的前外侧手术在 ACL 缺陷患者中的临床结果。
