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使用堆叠螺钉技术的单阶段翻修前交叉韧带重建术

Single-Stage Revision Anterior Cruciate Ligament Reconstruction Using the Stacked Screws Technique.

作者信息

Engler Ian D, Sylvia Stephen M, Salzler Matthew J, Forlizzi Julianne M, Gill Thomas J

机构信息

UPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.

Department of Orthopaedics, Tufts Medical Center, Boston, Massachusetts.

出版信息

Arthrosc Tech. 2022 Jun 21;11(7):e1341-e1345. doi: 10.1016/j.eats.2022.03.020. eCollection 2022 Jul.

DOI:10.1016/j.eats.2022.03.020
PMID:35936852
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9353588/
Abstract

Single-stage revision anterior cruciate ligament (ACL) reconstruction is preferable to 2-stage revision, when possible, as it avoids an additional surgery and recovery period. Malpositioned and/or widened bone tunnels are a common cause of ACL reconstruction failure and are challenging to manage in revision reconstructions. The "stacked screws construct" fills the previous malpositioned tunnels and bone voids with an oversized biocomposite screw as graft material. The revised tunnel can then be drilled in an anatomic "primary" location, even partially overlapping the filler screw. This technique simplifies tunnel management in revision ACL reconstruction.

摘要

单阶段翻修前交叉韧带（ACL）重建在可能的情况下优于两阶段翻修，因为它避免了额外的手术和恢复期。骨隧道位置不当和/或变宽是ACL重建失败的常见原因，并且在翻修重建中难以处理。“堆叠螺钉结构”使用超大号生物复合螺钉作为移植材料填充先前位置不当的隧道和骨缺损。然后可以在解剖学“原始”位置钻出翻修后的隧道，甚至部分与填充螺钉重叠。该技术简化了ACL翻修重建中的隧道处理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c95/9353588/3bada54a19ea/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c95/9353588/f4a794e212c8/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c95/9353588/2d3daabbffa4/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c95/9353588/98633d69e228/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c95/9353588/30b65402f091/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c95/9353588/3bada54a19ea/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c95/9353588/f4a794e212c8/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c95/9353588/2d3daabbffa4/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c95/9353588/98633d69e228/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c95/9353588/30b65402f091/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c95/9353588/3bada54a19ea/gr5.jpg

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本文引用的文献

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Stacked Biocomposite Screws in a Single-Stage Revision Anterior Cruciate Ligament Reconstruction Has Acceptable Fixation Strength in a Porcine Cadaveric Model.在猪尸体模型中，单阶段翻修前交叉韧带重建中使用堆叠式生物复合材料螺钉具有可接受的固定强度。
Am J Sports Med. 2021 Jul;49(8):2144-2149. doi: 10.1177/03635465211015192. Epub 2021 May 28.
2
Editorial Commentary: Anterior Cruciate Ligament Tunnel Aperture Overlap Determines Need for 1- Versus 2-Stage Revision: Setting the Stage.社论评论：前交叉韧带隧道开口重叠决定了是否需要 1 期或 2 期翻修：准备阶段。
Arthroscopy. 2021 Apr;37(4):1233-1234. doi: 10.1016/j.arthro.2021.01.033.
3
Effect of Delayed Primary Anterior Cruciate Ligament Reconstruction on Medial Compartment Cartilage and Meniscal Health.
延迟初次前交叉韧带重建对内侧间室软骨和半月板健康的影响。
Am J Sports Med. 2019 Jul;47(8):1816-1824. doi: 10.1177/0363546519849695. Epub 2019 May 24.
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Single-stage revision anterior cruciate ligament reconstruction using bone grafting for posterior or widening tibial tunnels restores stability of the knee and improves clinical outcomes.一期翻修前交叉韧带重建术采用植骨治疗后或增宽的胫骨隧道可恢复膝关节稳定性并改善临床结果。
Knee Surg Sports Traumatol Arthrosc. 2019 Nov;27(11):3713-3721. doi: 10.1007/s00167-019-05467-6. Epub 2019 Apr 12.
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Incidence of Anterior Cruciate Ligament Tears and Reconstruction: A 21-Year Population-Based Study.前交叉韧带撕裂与重建的发病率：一项基于人群的21年研究。
Am J Sports Med. 2016 Jun;44(6):1502-7. doi: 10.1177/0363546516629944. Epub 2016 Feb 26.
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Influence of Different Tibial Fixation Techniques on Initial Stability in Single-Stage Anterior Cruciate Ligament Revision With Confluent Tibial Tunnels: A Biomechanical Laboratory Study.不同胫骨固定技术对单阶段前交叉韧带翻修术中融合胫骨隧道初始稳定性的影响：一项生物力学实验室研究
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