Yiannakopoulos Christos K, Sachinis Nikolaos-Platon, Habipis Apostolos
Orthopaedic Department for Arthroscopic and Shoulder Surgery, IASO Hospital, Athens, Greece.
School of Physical Education & Sport Science, Sports Medicine & Exercise Biology Section, National & Kapodistrian University of Athens, Athens, Greece.
Arthrosc Tech. 2022 Dec 21;12(1):e65-e69. doi: 10.1016/j.eats.2022.08.059. eCollection 2023 Jan.
Efficient hamstring tendon harvesting is a crucial part of anterior cruciate ligament reconstruction surgery using autografts. Harvesting of the gracilis and semitendinosus tendons is usually performed using an open approach, exposing the distal tibial attachment of the tendons at the pes anserinus and proceeding using a tendon stripper without direct tendon visualization. The success of the anterior cruciate ligament reconstruction surgery strongly depends, among other factors, on the preservation of the hamstring tendon length and integrity. Inadequate tendon release from their attachments and improper use of the tendon stripper, in addition to poor intraoperative visibility, may lead to premature tendon amputation, endangering the success of the operation. We describe an endoscopic-assisted technique of hamstring tendon harvesting that provides complete visualization of the tendons from the tibia attachment to the musculotendinous junction. The procurement of the tendons is completed under direct vision using any tendon stripper. This surgical technique offers a way to minimize complications that may arise during the standard open tendon harvesting techniques without additional visualization.
高效获取腘绳肌腱是自体移植进行前交叉韧带重建手术的关键环节。通常采用开放手术方法获取股薄肌和半腱肌肌腱，暴露肌腱在鹅足处的胫骨远端附着点，然后使用肌腱剥离器进行操作，而无需直接观察肌腱。前交叉韧带重建手术的成功在很大程度上取决于多种因素，其中包括腘绳肌腱长度和完整性的保留。除了术中视野不佳外，肌腱从附着点释放不足以及肌腱剥离器使用不当，可能导致肌腱过早切断，危及手术成功。我们描述了一种内镜辅助的腘绳肌腱获取技术，该技术可提供从胫骨附着点到肌-腱交界处肌腱的完整视野。使用任何肌腱剥离器在直视下完成肌腱的获取。这种手术技术提供了一种方法，可将标准开放肌腱获取技术中可能出现的并发症降至最低，且无需额外的可视化操作。
