Santos Daniel Almeida Neto E, Rocha de Faria José Leonardo, Carminatti Tiago, Paula Rafael Erthal de, Pádua Vitor Barion Castro de, Pavão Douglas Melo, LaPrade Robert F, Helito Camilo Partezani
Andaraí Federal Hospital, Rio de Janeiro, RJ, Brazil.
Knee Surgery Center of the National Institute of Traumatology and Orthopedics of Brazil, Rio de Janeiro, RJ, Brazil.
Arthrosc Tech. 2023 May 15;12(6):e951-e958. doi: 10.1016/j.eats.2023.02.032. eCollection 2023 Jun.
The indications for combining anterior cruciate ligament reconstruction with anterolateral ligament reconstruction have increased considerably in recent years since several anatomical, clinical, and biomechanical studies have proven the importance of the anterolateral periphery in knee rotational stability. Much is still being discussed on how to combine these techniques in terms of which grafts and fixation options to use, as well as avoiding tunnel convergence. This study aims to describe anterior cruciate ligament reconstruction with a triple-bundle semitendinosus tendon graft all-inside technique combined with an anterolateral ligament reconstruction maintaining the gracilis tendon insertion on the tibia, using independent anatomical tunnels. With this, we were able to reconstruct both using only hamstring autografts, reducing morbidity in other possible donor areas, in addition to allowing stable fixation of both grafts without tunnel convergence.
近年来，由于多项解剖学、临床和生物力学研究证实了膝关节前外侧周边结构在旋转稳定性中的重要性，前交叉韧带重建联合前外侧韧带重建的适应证显著增加。关于如何结合这些技术，包括使用何种移植物和固定方式，以及避免隧道汇聚等问题，仍有很多讨论。本研究旨在描述一种采用全内置技术的三束半腱肌腱移植物进行前交叉韧带重建，并结合前外侧韧带重建，同时保留股薄肌腱在胫骨上的附着点，使用独立的解剖隧道。通过这种方法，我们能够仅使用腘绳肌自体移植物进行两者的重建，减少其他可能供区的并发症，此外还能实现两个移植物的稳定固定且不出现隧道汇聚。
