Tabatabaei Irani Pouya, Ayati Firoozabadi Mohammad, Toofan Hesam, Seyedtabaei Seyed Mohammad Milad, Poursalehian Mohammad, Ghasemian Mohammadmahdi, Mortazavi Seyed Mohammad Javad
Joint Reconstruction Research Center, Orthopedic Surgery Department, Imam Khomeini Hospital, Tehran, Iran.
Arthrosc Tech. 2023 Dec 4;13(1):102806. doi: 10.1016/j.eats.2023.08.011. eCollection 2024 Jan.
The anterior cruciate ligament (ACL) is often vulnerable to sports-related injuries, leading to numerous ACL reconstructions (ACLRs) annually in the United States. Although largely successful, these procedures face the risk of recurrent instability due to graft failure. ACLR failures are typically attributed to technical errors and patient-related factors, with improper positioning of the tibial and femoral tunnels as the most common technical mistake. Current 2-stage revision techniques involve primary bone grafting followed by secondary tendon graft placement, resulting in increased costs and extended rehabilitation times. This article proposes a single-stage revision strategy involving simultaneous tunnel grafting and ACLR revision. The method employs double suspensory fixation by adjustable loop buttons, thereby eliminating the dependence on metaphyseal bone stock for stable graft fixation. This new procedure may offer a more efficient and cost-effective approach, reducing the need for a second surgery and potentially allowing patients to return to normal activities more quickly.
前交叉韧带（ACL）经常容易受到与运动相关的损伤，导致美国每年有大量的ACL重建手术（ACLR）。尽管这些手术在很大程度上是成功的，但由于移植物失败，这些手术面临着复发性不稳定的风险。ACLR失败通常归因于技术错误和患者相关因素，其中胫骨和股骨隧道定位不当是最常见的技术错误。目前的两阶段翻修技术包括一期植骨，随后进行二期肌腱移植物植入，这导致成本增加和康复时间延长。本文提出了一种单阶段翻修策略，包括同时进行隧道移植物植入和ACLR翻修。该方法采用可调环扣进行双重悬吊固定，从而消除了对干骺端骨量进行稳定移植物固定的依赖。这种新手术可能提供一种更高效且具成本效益的方法，减少二次手术的需求，并有可能使患者更快恢复正常活动。
