Laupattarakasem Pat, Laupattarakasem Wiroon
Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Orthopaedic Center, Bangkok Hospital Khon Kaen, Khon Kaen, Thailand.
Arthrosc Tech. 2022 Dec 21;12(1):e91-e99. doi: 10.1016/j.eats.2022.08.063. eCollection 2023 Jan.
Lateral collateral ligament (LCL) is known as an important ligament to restrain varus force of the knee, especially in 30° knee flexion. From the anatomical study, the insertion of LCL at proximal fibula is intimately close to the insertion of biceps femoris (BF) tendon. Since LCL is infrequently injured in isolation, and with limitation in availability of autograft and allograft, this study proposes the partial anterior BF tendon as an alternative autograft source to reconstruct the LCL. This could be performed either by minimally invasive procedure or standard open technique. The core concept is to preserve the posterior part of the BF tendon to protect the peroneal nerve, by which exploration of this nerve and the proximal fibula prior to LCL reconstruction could be exempted. Minimally invasive LCL reconstruction using this autograft would essentially reduce soft tissue injury, shorten the operative time, and enhance recovery of the reconstructed knee.
外侧副韧带(LCL)是限制膝关节内翻力的重要韧带,尤其是在膝关节屈曲30°时。解剖学研究表明,LCL在腓骨近端的附着点与股二头肌(BF)肌腱的附着点紧密相邻。由于LCL很少单独损伤,且自体移植物和同种异体移植物的可用性有限,本研究提出将部分股二头肌前肌腱作为重建LCL的替代自体移植物来源。这可以通过微创手术或标准开放技术进行。核心概念是保留股二头肌肌腱的后部以保护腓总神经,这样在LCL重建之前就无需探查该神经和腓骨近端。使用这种自体移植物进行微创LCL重建将从根本上减少软组织损伤,缩短手术时间,并促进重建膝关节的恢复。