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使用韧带增强系统的解剖双束经胫骨前交叉韧带重建术

Anatomic Double-Bundle Transtibial Anterior Cruciate Ligament Reconstruction With Ligament Advanced Reinforcement System.

作者信息

Tang Jin, Zhao Jinzhong

机构信息

Operating Theater, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Department of Sports Medicine, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Arthrosc Tech. 2024 May 4;13(8):103014. doi: 10.1016/j.eats.2024.103014. eCollection 2024 Aug.

DOI:10.1016/j.eats.2024.103014
PMID:39233793
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11369952/
Abstract

It has been reported that anterior cruciate ligament reconstruction (ACLR) with the Ligament Advanced Reinforcement System (LARS) could obtain similar clinical outcomes to ACLR with autograft. However, in most related reports, single-bundle ACLR was performed. Given that double-bundle ACLR is more favorable than single-bundle ACLR biomechanically, it is reasonable to try double-bundle ACLR with the LARS clinically. Thus, we introduce an anatomic double-bundle transtibial ACLR technique with the LARS, in which the most critical step is to create a shallow tibial tunnel for the anteromedial bundle to further create the corresponding femoral tunnel in a transtibial manner, as well as to fix both bundles in full extension of the knee.

摘要

据报道，使用韧带增强系统（LARS）进行前交叉韧带重建（ACLR）可获得与自体移植ACLR相似的临床效果。然而，在大多数相关报告中，均采用单束ACLR。鉴于双束ACLR在生物力学上比单束ACLR更具优势，临床上尝试使用LARS进行双束ACLR是合理的。因此，我们介绍一种使用LARS的解剖双束经胫骨ACLR技术，其中最关键的步骤是为前内侧束创建一个浅胫骨隧道，以便以经胫骨的方式进一步创建相应的股骨隧道，并在膝关节完全伸直时固定两束。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/45500e5ed8ee/gr11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/189d721fde8a/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/a55dea982ac7/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/b3b3e9559466/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/5f563551ce9b/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/14183998d747/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/e3bfaa7c43d3/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/70721f3b1c6e/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/bcd56e6f18c3/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/c431c363d7d4/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/75289190c75e/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/45500e5ed8ee/gr11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/189d721fde8a/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/a55dea982ac7/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/b3b3e9559466/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/5f563551ce9b/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/14183998d747/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/e3bfaa7c43d3/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/70721f3b1c6e/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/bcd56e6f18c3/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/c431c363d7d4/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/75289190c75e/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6346/11369952/45500e5ed8ee/gr11.jpg

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本文引用的文献

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BMC Musculoskelet Disord. 2022 Dec 30;23(1):1140. doi: 10.1186/s12891-022-05984-5.
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Comparison of proprioception recovery following anterior cruciate ligament reconstruction using an artificial graft versus an autograft.前交叉韧带重建中使用人工移植物与自体移植物后本体感觉恢复的比较。
BMC Musculoskelet Disord. 2022 Dec 3;23(1):1056. doi: 10.1186/s12891-022-06019-9.
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Predicting the Objective and Subjective Clinical Outcomes of Anterior Cruciate Ligament Reconstruction: A Machine Learning Analysis of 432 Patients.
预测前交叉韧带重建的客观和主观临床结果：对432例患者的机器学习分析
Am J Sports Med. 2022 Dec;50(14):3786-3795. doi: 10.1177/03635465221129870. Epub 2022 Oct 26.
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The efficacy and medium-term outcomes of ligament advanced reinforcement system compared with auto-grafts in anterior cruciate ligament reconstruction: At least 2 years follow-up.前交叉韧带重建中韧带先进增强系统与自体移植物相比的疗效及中期结果：至少2年随访
Front Bioeng Biotechnol. 2022 Sep 2;10:960075. doi: 10.3389/fbioe.2022.960075. eCollection 2022.
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Relooking at double-bundle versus single-bundle anterior cruciate ligament reconstruction: A biomechanical model to evaluate which can confer better rotatory stability.重新审视双束与单束前交叉韧带重建：一种生物力学模型，评估哪种方法可以提供更好的旋转稳定性。
Clin Biomech (Bristol). 2022 Oct;99:105758. doi: 10.1016/j.clinbiomech.2022.105758. Epub 2022 Sep 5.
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Bone Joint J. 2022 Feb;104-B(2):242-248. doi: 10.1302/0301-620X.104B2.BJJ-2021-0798.R2.
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Treatment results and safety assessment of the LARS system for the reconstruction of the anterior cruciate ligament.LARS 系统在前交叉韧带重建中的治疗效果和安全性评估。
Adv Clin Exp Med. 2021 Apr;30(4):379-386. doi: 10.17219/acem/132037.
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