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后外侧角重建:使用自体腘绳肌腱移植物改良LaPrade技术:“腘腓环”

Posterolateral Corner Reconstruction: Modification of the LaPrade Technique Using Autologous Hamstring Tendon Grafts: "The Popliteofibular Loop".

作者信息

Mestriner Marcos Barbieri, Oliveira Victor Marques de, Guglielmetti Luiz Gabriel Betoni, Aihara Leandro Jun, Severino Nilson Roberto, Cury Ricardo de Paula Leite

机构信息

Knee Surgery Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa of São Paulo, Sao Paulo, SP, Brazil.

出版信息

Arthrosc Tech. 2024 Jan 1;13(2):102852. doi: 10.1016/j.eats.2023.09.027. eCollection 2024 Feb.

Abstract

Posterolateral corner (PLC) injury is a significant cause of knee instability. In recent years, a better understanding of the anatomy and biomechanics of the PLC structures has led to significant advancements in the surgical treatment of this injury. Anatomical reconstruction techniques, particularly the LaPrade technique, have shown promising results. However, in some settings, the reliance on allografts limits the feasibility of this technique, prompting surgeons to seek reproducible alternatives that use autologous grafts, eliminating the need for tissue banks. The purpose of this Technical Note is to describe a modification of the LaPrade technique for PLC reconstruction using autologous hamstring tendon grafts. The surgical technique is described to ensure reproducibility, with particular emphasis on the proposed modifications: the use of autologous grafts (gracilis and semitendinosus tendons); the configuration in which they are used to increase the thickness of the reconstructed structures; and the exclusive fixation with widely available interference screws.

摘要

后外侧角(PLC)损伤是膝关节不稳定的重要原因。近年来,对PLC结构的解剖学和生物力学有了更深入的了解,这使得该损伤的手术治疗取得了重大进展。解剖重建技术,特别是LaPrade技术,已显示出令人满意的结果。然而,在某些情况下,对同种异体移植物的依赖限制了该技术的可行性,促使外科医生寻求使用自体移植物的可重复替代方法,从而无需组织库。本技术说明的目的是描述一种使用自体腘绳肌腱移植物对LaPrade技术进行改良以重建PLC的方法。描述了手术技术以确保可重复性,特别强调了所提议的改良之处:使用自体移植物(股薄肌和半腱肌肌腱);使用它们来增加重建结构厚度的配置;以及使用广泛可得的干涉螺钉进行的单纯固定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e689/10907909/631ee88f9903/gr1.jpg

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