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采用自体骨-髌腱-骨移植和外侧关节外肌腱固定术进行前交叉韧带翻修术

Anterior Cruciate Ligament Revision Using Bone-Patellar Tendon-Bone Autograft and Lateral Extra-articular Tenodesis.

作者信息

Ricchi Tommaso, Di Muro Andrea, Taha Zyad Ayman, Franco Piero, Matassi Fabrizio

机构信息

Department of Orthopaedics, University Hospital of Florence - A.O.U. Careggi, Florence, Italy.

出版信息

Arthrosc Tech. 2024 Jul 25;13(12):103149. doi: 10.1016/j.eats.2024.103149. eCollection 2024 Dec.

DOI:10.1016/j.eats.2024.103149
PMID:39780896
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11704902/
Abstract

Revision of anterior cruciate ligament reconstruction presents various challenges not encountered in the primary settings, including malpositioned tunnels, tunnel widening, and the lack of consensus on the ideal graft to be used. This Technical Note describes a one-stage anterior cruciate ligament reconstruction revision using a bone-patellar tendon-bone autograft combined with lateral extra-articular tenodesis. This technique represents the ideal approach to tackle complex revision cases primarily characterized by tibial and femoral tunnel osteolysis and rotational knee instability. The bone-patellar tendon-bone autograft offers numerous advantages mainly providing a double bone plug, which is critical when encountering cases with tibial and femoral tunnel widening. In addition, a lateral extra-articular tenodesis alongside the revision enhances rotational knee stability reducing stress on the graft and ensuring better graft survival.

摘要

前交叉韧带重建翻修术面临着一些在初次手术时未遇到的挑战，包括隧道位置不当、隧道增宽以及对于理想移植物的选择缺乏共识。本技术说明描述了一种使用自体骨-髌腱-骨移植物联合外侧关节外肌腱固定术的一期前交叉韧带重建翻修术。该技术是处理复杂翻修病例的理想方法，这些病例主要特征为胫骨和股骨隧道骨质溶解以及膝关节旋转不稳。自体骨-髌腱-骨移植物具有诸多优点，主要是提供了双骨栓，这在遇到胫骨和股骨隧道增宽的病例时至关重要。此外，在翻修手术的同时进行外侧关节外肌腱固定术可增强膝关节旋转稳定性，减轻移植物上的应力，并确保移植物更好地存活。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/b0ebab07c488/gr14.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/833d1de0c195/gr6.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/9dc3fc50f775/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/8e53481c2718/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/e8e8da0cafe0/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/76d42a4bbd57/gr11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/1cc9b9db1da7/gr12.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/0c578c92f798/gr13.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/b0ebab07c488/gr14.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/ae5c1c5cda0d/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/b6b47b82bae2/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/3cefbbd27f7e/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/645eecf891b0/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/b16ff5cf7d9f/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/833d1de0c195/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/71f4acadca9f/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/9dc3fc50f775/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/8e53481c2718/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/e8e8da0cafe0/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/76d42a4bbd57/gr11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/1cc9b9db1da7/gr12.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/0c578c92f798/gr13.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1796/11704902/b0ebab07c488/gr14.jpg

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