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同侧股四头肌肌腱-骨前交叉韧带翻修重建术，用于处理初次骨-髌腱-骨前交叉韧带重建失败且存在持续性髌骨关节面骨缺损的情况。

Ipsilateral Quadriceps Tendon-Bone ACL Revision Reconstruction to Address Failed Primary Bone-Patellar Tendon-Bone ACL Reconstruction with Persistent Patellar Bone Defect.

作者信息

Hetsroni Iftach, Fuchs Yuval, Mann Gideon, Ohana Nissim

机构信息

Department of Orthopedic Surgery, Meir General Hospital, Kfar Saba, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Arthrosc Tech. 2023 Mar 23;12(4):e491-e501. doi: 10.1016/j.eats.2022.11.032. eCollection 2023 Apr.

DOI:10.1016/j.eats.2022.11.032
PMID:37138693
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10150001/
Abstract

Bone-patellar tendon-bone (BPTB) autograft is a popular graft choice for anterior cruciate ligament reconstruction (ACLR) in active young adults. In case of BPTB ACLR failure, the 3 most popular autograft choices for a revision surgery include contralateral BPTB, contralateral or ipsilateral hamstrings autograft, and contralateral or ipsilateral quadriceps tendon autograft. Quadriceps tendon autograft has been gaining increasing popularity in recent years in this respect, but using quadriceps tendon-bone autograft in the setup of a previous use of ipsilateral BPTB autograft deserves special technical considerations, with emphasis on preserving patellar bone integrity. We describe a technique for performing revision ACLR after failed primary BPTB ACLR by using ipsilateral quadriceps tendon-bone autograft in the setup of persistent distal patellar bone defect. Using this autograft benefits the advantages of highly resilient graft tissue in addition to fast bone-to-bone healing on the femoral side, and it can be an excellent choice in revision reconstruction for surgeons who prefer tendon-bone autograft for highly active young adults and specifically when the patients underwent bilateral primary autologous BPTB ACLRs.

摘要

髌腱-骨（BPTB）自体移植物是活跃的年轻成年人前交叉韧带重建（ACLR）中常用的移植物选择。在BPTB ACLR失败的情况下，翻修手术中最常用的3种自体移植物选择包括对侧BPTB、对侧或同侧腘绳肌自体移植物以及对侧或同侧股四头肌肌腱自体移植物。近年来，股四头肌肌腱自体移植物在这方面越来越受欢迎，但在先前使用同侧BPTB自体移植物的情况下使用股四头肌肌腱-骨自体移植物需要特殊的技术考量，重点是保留髌骨骨的完整性。我们描述了一种在初次BPTB ACLR失败后，在存在持续性髌骨远端骨缺损的情况下使用同侧股四头肌肌腱-骨自体移植物进行翻修ACLR的技术。使用这种自体移植物除了在股骨侧具有快速骨对骨愈合的优点外，还具有高弹性移植物组织的优势，对于倾向于为高度活跃的年轻成年人使用肌腱-骨自体移植物的外科医生，特别是当患者接受双侧初次自体BPTB ACLR时，它可能是翻修重建的一个极佳选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd4/10150001/0329b9695ac5/gr12.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd4/10150001/2aebbf97238b/gr11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd4/10150001/0329b9695ac5/gr12.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd4/10150001/3556e6b42000/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd4/10150001/ee367e31bbc2/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd4/10150001/a22bc5726e39/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd4/10150001/97556ad7d6be/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd4/10150001/02e66ed904b2/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd4/10150001/8962cbf48716/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd4/10150001/19aacae86d03/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd4/10150001/eda401d0a14c/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd4/10150001/1492c56f45bc/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd4/10150001/966b5973d366/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd4/10150001/2aebbf97238b/gr11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd4/10150001/0329b9695ac5/gr12.jpg

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