Panas Kenton, Salomon Kevin, Shen Victor, Munassi Steven, Remaley D Trey
University of South Florida, Tampa, Florida, U.S.A.
Foundation for Orthopaedic Research and Education, Tampa, Florida, U.S.A.
Arthrosc Tech. 2022 Oct 22;11(11):e2067-e2072. doi: 10.1016/j.eats.2022.08.006. eCollection 2022 Nov.
Recent systematic reviews have shown anterior cruciate ligament reconstruction using quadriceps tendon (QT) grafts to have superior clinical outcomes compared with traditional bone-patella tendon-bone and hamstring tendons grafts. Using minimally invasive techniques to harvest the QT graft can reduce postoperative pain and intraoperative surgical time. This technique is usually performed with a distal-to-proximal approach but often has issues of inadvertently harvesting a graft short of the desired length or causing a hematoma. As an alternative, we introduce a minimally invasive approach with a proximal-to-distal harvest technique that results in better visualization of tissue planes, more consistent graft sizes, lower risk of inadvertent arthrotomy, and reduced risk of hematoma. The minimally invasive QT graft harvest with a proximal-to-distal approach can offer unique advantages over the current standard distal-to-proximal approach.
近期的系统评价表明，与传统的骨-髌腱-骨和腘绳肌腱移植物相比，采用股四头肌腱（QT）移植物进行前交叉韧带重建具有更好的临床效果。使用微创技术获取QT移植物可减轻术后疼痛并缩短术中手术时间。该技术通常采用从远端到近端的入路，但常常存在无意中获取的移植物长度不足或导致血肿的问题。作为一种替代方法，我们引入了一种采用从近端到远端获取技术的微创入路，该技术能更好地观察组织层面，使移植物尺寸更一致，意外切开关节的风险更低，血肿风险也降低。与当前标准的从远端到近端入路相比，采用从近端到远端入路的微创QT移植物获取方法具有独特优势。
