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关节镜下保留残端的三通道后交叉韧带重建术:移植物反向穿入

Arthroscopic Remnant Preserving 3-Portal Posterior Cruciate Ligament Reconstruction With Reverse Passage of the Graft.

作者信息

Hermanowicz Krzysztof, Mrozek Tomasz, Góralczyk Adrian, Jancewicz Piotr, Dołżyńska Aleksandra, Szajwa Laura, Hermanowicz Julia

机构信息

ORTIM Orthopaedic Clinic, Bialystok, Poland.

Department of Orthopedics and Traumatology, Hospital of Ministry of Internal Affairs and Administration, Białystok, Poland.

出版信息

Arthrosc Tech. 2023 Apr 16;12(5):e621-e627. doi: 10.1016/j.eats.2022.12.018. eCollection 2023 May.

Abstract

The posterior cruciate ligament (PCL) is the largest and strongest ligament of the knee, with a tremendous role as the primary posterior stabilizer of the knee. Surgical management of PCL injuries is very demanding, due to the fact that the PCL tear usually is a part of multiligamentous knee injury. Moreover, PCL anatomy, especially its course and attachment points to femur and tibia, makes reconstruction of the PCL technically challenging. The main pitfall is the sharp angle between created during reconstruction surgery bony tunnels, which forms so called "killer turn". The authors present a technique of the remnant-preserving PCL arthroscopic reconstruction that simplifies the procedure and uses the method of reverse passage of the PCL graft to overcome the killer turn.

摘要

后交叉韧带(PCL)是膝关节最大且最强壮的韧带,作为膝关节主要的后向稳定结构发挥着巨大作用。由于PCL撕裂通常是膝关节多韧带损伤的一部分,PCL损伤的手术治疗极具挑战性。此外,PCL的解剖结构,尤其是其在股骨和胫骨上的走行及附着点,使得PCL重建在技术上具有挑战性。主要的陷阱是在重建手术中形成的骨隧道之间的锐角,即所谓的“致命转角”。作者介绍了一种保留残端的PCL关节镜重建技术,该技术简化了手术过程,并采用PCL移植物逆行穿过的方法来克服致命转角。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1145/10265273/5f6b7987e282/gr1.jpg

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