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同期内侧单髁膝关节置换与前交叉韧带重建：一篇叙述性综述及技术说明

Simultaneous medial unicompartmental knee replacement and anterior cruciate ligament reconstruction: a narrative review and technical note.

作者信息

Macchiarola Luca, Espinosa Maximiliano, Pirone Massimo, Lucidi Gian Andrea, Cucurnia Ilaria, Grassi Alberto, Marín Fermín Theodorakys, Zaffagnini Stefano

机构信息

Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Foggia, Foggia, Italy.

出版信息

Ann Jt. 2023 Jan 12;8:6. doi: 10.21037/aoj-22-7. eCollection 2023.

DOI:10.21037/aoj-22-7
PMID:38529248
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10929284/
Abstract

BACKGROUND AND OBJECTIVE

Reconstruction of the anterior cruciate ligament (ACL) simultaneously with medial unicompartmental knee arthroplasty (UKA) has been suggested as an alternative treatment in patients with ACL deficiency and localized osteoarthritis (OA) in young patients. The objectives of this review were to report the current concepts on the topic and describe an original surgical technique of simultaneous medial UKA and ACL reconstruction.

METHODS

A literature search was performed on PubMed, including articles written in English until June 2021. The articles regarding ACL reconstruction and UKA were reviewed using the narrative approach. Inclusion criteria: (I) original articles about ACL reconstruction and unicompartmental knee replacement; (II) written in English; (III) involving three or more cases. Two non-blinded authors reviewed the titles and abstracts of each article identified in the literature search.

KEY CONTENT AND FINDINGS

The articles regarding ACL reconstruction and UKA were reviewed using the narrative approach.

CONCLUSIONS

There is controversial evidence about performing the UKA simultaneously with an ACL reconstruction. Biomechanical and clinical studies show that the benefits of restoring good joint stability outweigh the possible risks associated with performing both surgeries at the same time. With this strategy, it is possible to obtain good clinical results with a high survival rate of the implant and patient satisfaction.

摘要

背景与目的

对于年轻患者中存在前交叉韧带（ACL）损伤及局限性骨关节炎（OA）的情况，有人提出在进行内侧单髁膝关节置换术（UKA）的同时重建ACL作为一种替代治疗方法。本综述的目的是报告该主题的当前概念，并描述一种同时进行内侧UKA和ACL重建的原创手术技术。

方法

在PubMed上进行文献检索，包括截至2021年6月用英文撰写的文章。使用叙述性方法对有关ACL重建和UKA的文章进行综述。纳入标准：（I）关于ACL重建和单髁膝关节置换的原创文章；（II）用英文撰写；（III）涉及三个或更多病例。两位非盲法作者对文献检索中确定的每篇文章的标题和摘要进行了审查。

关键内容与发现

使用叙述性方法对有关ACL重建和UKA的文章进行了综述。

结论

关于同时进行UKA和ACL重建存在有争议的证据。生物力学和临床研究表明，恢复良好的关节稳定性的益处超过了同时进行这两种手术可能带来的风险。采用这种策略，可以获得良好的临床结果，植入物的生存率高且患者满意度高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe7/10929284/9ee0f7d0ef62/aoj-08-6-f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe7/10929284/a92279f2bb42/aoj-08-6-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe7/10929284/e0889d48ff11/aoj-08-6-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe7/10929284/e8b68c26fb3f/aoj-08-6-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe7/10929284/e33a049686aa/aoj-08-6-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe7/10929284/b7374693f66e/aoj-08-6-f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe7/10929284/b939dbebd4a5/aoj-08-6-f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe7/10929284/9ee0f7d0ef62/aoj-08-6-f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe7/10929284/a92279f2bb42/aoj-08-6-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe7/10929284/e0889d48ff11/aoj-08-6-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe7/10929284/e8b68c26fb3f/aoj-08-6-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe7/10929284/e33a049686aa/aoj-08-6-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe7/10929284/b7374693f66e/aoj-08-6-f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe7/10929284/b939dbebd4a5/aoj-08-6-f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe7/10929284/9ee0f7d0ef62/aoj-08-6-f7.jpg

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