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髂胫束的卡普兰纤维:当前文献综述

Kaplan fibers of iliotibial band: a comprehensive review of current literature.

作者信息

Poursalehian Mohammad, Hajiaghajani Sina, Ayati Firoozabadi Mohammad, Dehghani Ashkezari Davood, Mortazavi Seyed Mohammad Javad

机构信息

Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

EFORT Open Rev. 2024 Oct 3;9(10):980-989. doi: 10.1530/EOR-24-0017.

Abstract

This review highlights the pivotal role of Kaplan fibers (KFs) in knee stability, particularly in the anterolateral aspect. Studies reveal their complex anatomy with varying attachments to the distal femur, demonstrating a significant impact on knee joint mechanics across different populations. Investigations into the biomechanics of KFs show their crucial role in maintaining rotational stability of the knee, especially during rotational movements. Their synergistic function with other knee structures, like the anterolateral ligament, is emphasized, underscoring their importance in knee integrity and function. MRI emerges as a key tool in detecting KFs, with varying visibility and prevalence of injuries. The review discusses the development of MRI criteria for accurate diagnosis, highlighting the need for further research to refine these criteria and understand the interplay between KF injuries, anterior cruciate ligament (ACL) ruptures, and associated knee pathologies. The review covers various lateral extra-articular tenodesis (LET) techniques used to address residual laxity and instability following ACL reconstruction. Among them, the modified Lemaire technique, which resembles the anatomical and functional characteristics of distal KFs, shows effectiveness in reducing internal rotation and residual laxity. The review emphasizes the need for further research to understand the healing dynamics of KF injuries and the efficacy of different LET techniques. It suggests that a comprehensive approach, considering both biomechanical and clinical aspects, is crucial for advancing knee joint health and rehabilitation.

摘要

本综述强调了卡普兰纤维(KFs)在膝关节稳定性中的关键作用,尤其是在前外侧方面。研究揭示了它们复杂的解剖结构,其在股骨远端有不同的附着点,表明对不同人群的膝关节力学有显著影响。对KFs生物力学的研究表明它们在维持膝关节旋转稳定性方面起着关键作用,特别是在旋转运动期间。强调了它们与其他膝关节结构(如前外侧韧带)的协同功能,突出了它们在膝关节完整性和功能中的重要性。磁共振成像(MRI)成为检测KFs的关键工具,其损伤的可见性和发生率各不相同。本综述讨论了用于准确诊断的MRI标准的发展,强调需要进一步研究以完善这些标准,并了解KF损伤、前交叉韧带(ACL)断裂及相关膝关节病变之间的相互作用。本综述涵盖了用于解决ACL重建后残留松弛和不稳定问题的各种外侧关节外腱固定术(LET)技术。其中,改良勒梅尔技术类似于远端KFs的解剖和功能特征,在减少内旋和残留松弛方面显示出有效性。本综述强调需要进一步研究以了解KF损伤的愈合动态以及不同LET技术的疗效。它表明,考虑生物力学和临床方面的综合方法对于促进膝关节健康和康复至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecbd/11457805/a387250cb383/EOR-24-0017fig1.jpg

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