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[膝关节后外侧不稳定]

[Posterolateral instability of the knee joint].

作者信息

Berninger M T, Drenck T C, Frings J, Krause M, Frosch K-H

机构信息

Klinik und Poliklinik für Unfallchirurgie und Orthopädie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.

Abteilung für Unfallchirurgie, Orthopädie und Sporttraumatologie, BG Klinikum Hamburg, Hamburg, Deutschland.

出版信息

Orthopadie (Heidelb). 2024 Apr;53(4):297-307. doi: 10.1007/s00132-024-04478-7. Epub 2024 Feb 20.

DOI:10.1007/s00132-024-04478-7
PMID:38376535
Abstract

The posterolateral corner of the knee is composed of a multilayered complex of ligamentous, musculotendinous, and capsular structures, which interact in a synergistic stabilizing manner with the central structures, particularly the posterior cruciate ligament. Injuries of the posterolateral corner are generally accompanied by rupture of the posterior cruciate ligament. Depending on the injured structures, injuries of the posterolateral corner result in posterolateral rotational instability alone (Fanelli A) or with lateral instability (Fanelli B/C). For rotational instability alone, isolated popliteus bypass is an effective procedure; with concomitant lateral instability in flexion, additional stabilization of the lateral collateral ligament is required. Most of the various available techniques are described as open reconstruction procedures. In recent years, arthroscopic techniques for posterolateral reconstruction have also been successfully developed.

摘要

膝关节后外侧角由韧带、肌腱和关节囊结构组成的多层复合体构成,这些结构与中央结构,特别是后交叉韧带以协同稳定的方式相互作用。后外侧角损伤通常伴有后交叉韧带断裂。根据损伤结构的不同,后外侧角损伤可单独导致后外侧旋转不稳定(法内利A型)或伴有外侧不稳定(法内利B/C型)。对于单纯旋转不稳定,孤立的腘肌替代术是一种有效的手术方法;对于伴有屈曲时的外侧不稳定,则需要额外稳定外侧副韧带。现有的各种技术大多被描述为开放重建手术。近年来,后外侧重建的关节镜技术也已成功开发。

相似文献

1
[Posterolateral instability of the knee joint].[膝关节后外侧不稳定]
Orthopadie (Heidelb). 2024 Apr;53(4):297-307. doi: 10.1007/s00132-024-04478-7. Epub 2024 Feb 20.
2
The Popliteus Bypass provides superior biomechanical properties compared to the Larson technique in the reconstruction of combined posterolateral corner and posterior cruciate ligament injury.腘肌腱转位术在重建合并后外侧角和后十字韧带损伤中,其生物力学性能优于 Larson 技术。
Knee Surg Sports Traumatol Arthrosc. 2021 Mar;29(3):732-741. doi: 10.1007/s00167-020-05987-6. Epub 2020 May 5.
3
How well do anatomical reconstructions of the posterolateral corner restore varus stability to the posterior cruciate ligament-reconstructed knee?后外侧角的解剖重建能在多大程度上恢复后交叉韧带重建膝关节的内翻稳定性?
Am J Sports Med. 2007 Jul;35(7):1117-22. doi: 10.1177/0363546507299240.
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Posterolateral knee reconstruction.膝关节后外侧重建
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Clinical results after arthroscopic reconstruction of the posterolateral corner of the knee: A prospective randomized trial comparing two different surgical techniques.关节镜下重建膝关节后外侧角的临床结果:两种不同手术技术的前瞻性随机试验。
Arch Orthop Trauma Surg. 2023 Feb;143(2):967-975. doi: 10.1007/s00402-022-04403-7. Epub 2022 Mar 27.
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The treatment of posterolateral knee instability with combined arthroscopic popliteus bypass and PCL reconstruction provides good-to-excellent clinical results in the mid-term follow-up.关节镜下联合腘肌旁路术和后交叉韧带重建治疗膝关节后外侧不稳,在中期随访中临床效果良好至优秀。
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Posterolateral corner of the knee: a systematic literature review of current concepts of arthroscopic reconstruction.膝关节后外侧角:关节镜重建当前概念的系统文献回顾。
Arch Orthop Trauma Surg. 2020 Dec;140(12):2003-2012. doi: 10.1007/s00402-020-03607-z. Epub 2020 Sep 21.
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[Imaging of posterolateral rotational instability of the knee joint].[膝关节后外侧旋转不稳定的影像学表现]
Radiologie (Heidelb). 2024 Apr;64(4):271-277. doi: 10.1007/s00117-023-01258-w. Epub 2024 Jan 30.
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Posterolateral reconstruction using split Achilles tendon allograft.采用异体跟腱移植进行后外侧重建。
Arthroscopy. 2003 Nov;19(9):1043-9. doi: 10.1016/j.arthro.2003.09.037.
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Injuries to the posterior cruciate ligament and posterolateral instabilities of the knee.膝关节后交叉韧带损伤及后外侧不稳定
Chang Gung Med J. 2002 May;25(5):288-97.

引用本文的文献

1
Injury of the posterolateral corner of the knee does not lead to higher intra-articular external tibial rotation in the MRI.膝关节后外侧角损伤在磁共振成像(MRI)中不会导致关节内胫骨外旋增加。
J Exp Orthop. 2025 Jul 13;12(3):e70360. doi: 10.1002/jeo2.70360. eCollection 2025 Jul.

本文引用的文献

1
Clinical results after arthroscopic reconstruction of the posterolateral corner of the knee: A prospective randomized trial comparing two different surgical techniques.关节镜下重建膝关节后外侧角的临床结果:两种不同手术技术的前瞻性随机试验。
Arch Orthop Trauma Surg. 2023 Feb;143(2):967-975. doi: 10.1007/s00402-022-04403-7. Epub 2022 Mar 27.
2
Reconstruction of the Posterolateral Corner of the Knee Using LaPrade and Modified Larson Technique: A Prospective Study.使用拉普雷德和改良拉森技术重建膝关节后外侧角:一项前瞻性研究。
Indian J Orthop. 2021 Jun 29;56(1):125-132. doi: 10.1007/s43465-021-00435-0. eCollection 2022 Jan.
3
Posterolateral corner of the knee: a systematic literature review of current concepts of arthroscopic reconstruction.
膝关节后外侧角:关节镜重建当前概念的系统文献回顾。
Arch Orthop Trauma Surg. 2020 Dec;140(12):2003-2012. doi: 10.1007/s00402-020-03607-z. Epub 2020 Sep 21.
4
The Posterolateral Instability Score (PoLIS) of the knee joint: a guideline for standardized documentation, classification, and surgical decision-making.膝关节后外侧不稳定评分(PoLIS):标准化记录、分类及手术决策指南
Knee Surg Sports Traumatol Arthrosc. 2021 Mar;29(3):889-899. doi: 10.1007/s00167-020-06044-y. Epub 2020 May 27.
5
The Popliteus Bypass provides superior biomechanical properties compared to the Larson technique in the reconstruction of combined posterolateral corner and posterior cruciate ligament injury.腘肌腱转位术在重建合并后外侧角和后十字韧带损伤中,其生物力学性能优于 Larson 技术。
Knee Surg Sports Traumatol Arthrosc. 2021 Mar;29(3):732-741. doi: 10.1007/s00167-020-05987-6. Epub 2020 May 5.
6
The superficial medial collateral ligament is the major restraint to anteromedial instability of the knee.浅层内侧副韧带是膝关节前内侧不稳定的主要限制因素。
Knee Surg Sports Traumatol Arthrosc. 2021 Feb;29(2):405-416. doi: 10.1007/s00167-020-05947-0. Epub 2020 Apr 10.
7
Large variability exists in the management of posterolateral corner injuries in the global surgical community.在后外侧角损伤的处理上,全球外科医生群体的做法存在较大差异。
Knee Surg Sports Traumatol Arthrosc. 2020 Jul;28(7):2116-2123. doi: 10.1007/s00167-020-05922-9. Epub 2020 Apr 1.
8
The effects of soft tissue lateral release on the stability of the ligament complex of the knee.软组织外侧松解术对膝关节韧带复合体稳定性的影响。
Arch Orthop Trauma Surg. 2020 Jul;140(7):933-940. doi: 10.1007/s00402-020-03422-6. Epub 2020 Mar 30.
9
Posterolateral corner reconstruction in combined injuries of the knee: Improved stability with Larson's fibular sling reconstruction and comparison with LaPrade anatomical reconstruction.膝关节复合伤的后外侧角重建:Larson腓骨吊带重建改善稳定性及与LaPrade解剖重建的比较
Knee. 2020 Jan;27(1):124-131. doi: 10.1016/j.knee.2019.09.008. Epub 2019 Dec 26.
10
An All-Arthroscopic Technique for Complex Posterolateral Corner Reconstruction.一种用于复杂后外侧角重建的全关节镜技术。
Arthrosc Tech. 2019 Sep 11;8(9):e999-e1006. doi: 10.1016/j.eats.2019.05.010. eCollection 2019 Sep.