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使用股四头肌肌腱自体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 Quadriceps Tendon Autograft and Lateral Extra-Articular Tenodesis.

作者信息

Matassi Fabrizio, Corti Jacopo, Chirico Mattia, Franco Piero, Taha Zyad Ayman, Civinini Roberto

机构信息

From the Università degli studi di Firenze - Careggi, Florence, Italy.

出版信息

Arthrosc Tech. 2024 Aug 16;14(1):103163. doi: 10.1016/j.eats.2024.103163. eCollection 2025 Jan.

DOI:10.1016/j.eats.2024.103163
PMID:39989689
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11843292/
Abstract

Revision of anterior cruciate ligament (ACL) reconstruction presents numerous challenges not encountered in the primary setting and therefore requires thorough preoperative planning. Addressing tunnel widening is the primary concern, and therefore the appropriate graft choice is pivotal. Quadriceps tendon autograft recently has gained popularity for its dimensions and the possibility to harvest a bone block from the patella that can fill potential tunnel bone defects. Adjunctive procedures to isolated ACL reconstruction such as lateral extra-articular tenodesis (LET) may help in sharing the loads with the neoligament, with recent findings recommending LET in the revision setting. The technique presented in this Technical Note describes a 1-stage revision ACL combined with LET using a quadriceps tendon autograft with a bone plug.

摘要

前交叉韧带（ACL）重建翻修面临着初次手术时未遇到的诸多挑战，因此需要进行全面的术前规划。解决隧道扩大问题是首要关注点，因此合适的移植物选择至关重要。股四头肌腱自体移植物近来因其尺寸以及能够从髌骨获取骨块以填充潜在隧道骨缺损的可能性而受到青睐。诸如外侧关节外肌腱固定术（LET）等孤立ACL重建的辅助手术可能有助于与新韧带分担负荷，近期研究结果建议在翻修手术中采用LET。本技术说明中介绍的技术描述了一种使用带骨栓的股四头肌腱自体移植物进行的一期ACL翻修联合LET手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5325/11843292/6b0fa03c5f58/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5325/11843292/8e9dce1a173b/gr1.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5325/11843292/b8fe55094433/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5325/11843292/110e1b362c3c/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5325/11843292/6b0fa03c5f58/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5325/11843292/8e9dce1a173b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5325/11843292/2dccec0412e3/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5325/11843292/d15bbf491424/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5325/11843292/3c5b2522ffdd/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5325/11843292/a2137cfc330a/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5325/11843292/bf76fd4051c8/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5325/11843292/aca516a0a698/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5325/11843292/b8fe55094433/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5325/11843292/110e1b362c3c/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5325/11843292/6b0fa03c5f58/gr10.jpg

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本文引用的文献

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Both Quadriceps and Bone-Patellar Tendon-Bone Autografts Improve Postoperative Stability and Functional Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review.股四头肌和髌腱-骨自体移植物均能改善前交叉韧带重建术后的稳定性和功能结果：一项系统评价。
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Role of Quadriceps Tendon Autograft in Primary and Revision Anterior Cruciate Ligament Reconstruction.股四头肌腱自体移植物在初次和翻修前交叉韧带重建中的作用
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Quadriceps tendon autograft has similar clinical outcomes when compared to hamstring tendon and bone-patellar tendon-bone autografts for revision ACL reconstruction: a systematic review and meta-analysis.
与腘绳肌腱和骨-髌腱-骨自体移植物相比，股四头肌肌腱自体移植物用于翻修前交叉韧带重建时具有相似的临床疗效：一项系统评价和荟萃分析。
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Association Between Graft Type and Risk of Repeat Revision Anterior Cruciate Ligament Reconstruction: A Cohort Study of 1747 Patients.移植物类型与前交叉韧带重建翻修风险的关联：一项 1747 例患者的队列研究。
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Controversies in ACL revision surgery: Italian expert group consensus and state of the art.前交叉韧带重建术的争议：意大利专家组共识与技术现状。
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Arthroscopic confirmation of femoral button deployment avoids post-operative X-ray in ACL reconstruction.关节镜确认股骨纽扣的部署可避免 ACL 重建术后的 X 射线检查。
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