Gupta Sheetal, Ashish B C, Chavan Sachin K, Gupta Pakhi
Galaxy Hospital, Bhopal, India.
Arthrosc Tech. 2023 Nov 6;12(12):e2141-e2151. doi: 10.1016/j.eats.2023.07.039. eCollection 2023 Dec.
Injury to the superficial medial collateral ligament (MCL) is treated conservatively for low-grade injury and with surgery for high-grade injury, especially in association with cruciate ligament injury. Acute injuries are treated with MCL repair, and chronic injury requires reconstruction. Anatomic MCL reconstruction can be done using free allograft or autograft and fixed using screws or suspensory fixation. We describe here an anatomic technique that is a modification of a Danish technique in which we reroute the semitendinosus, keeping its tibial attachment intact. The semitendinosus is rerouted anatomically in the tibial tunnel, and a graft is then passed anatomically in the femoral tunnel. The graft is fixed in both tunnels with adjustable loop suspensory fixation, which gives the unique advantage of controlled tensioning of the graft for MCL reconstruction. In this technique further re-tensioning is possible if the knee is unstable in valgus stress, even after final fixation.
内侧副韧带浅层损伤，低度损伤采用保守治疗，高度损伤则行手术治疗，尤其是合并交叉韧带损伤时。急性损伤采用内侧副韧带修复术，慢性损伤则需重建。解剖学内侧副韧带重建可使用游离同种异体移植物或自体移植物，并使用螺钉或悬吊固定。我们在此描述一种解剖学技术，它是对丹麦技术的改良，在该技术中我们重新调整半腱肌的路径，同时保持其胫骨附着点完整。半腱肌在胫骨隧道内按解剖学路径重新调整，然后将移植物按解剖学路径穿过股骨隧道。移植物在两个隧道内均采用可调节袢悬吊固定，这为内侧副韧带重建提供了控制移植物张力的独特优势。在该技术中，如果膝关节在 valgus 应力下仍不稳定，即使在最终固定后，仍可进一步重新张紧。
