Daniel Adam V, Smith Patrick A
From Columbia Orthopaedic Group, Columbia, Missouri, U.S.A.
Arthrosc Tech. 2024 Aug 27;14(2):103200. doi: 10.1016/j.eats.2024.103200. eCollection 2025 Feb.
Injury to the medial complex of the knee may result in persisting valgus and rotatory instability. In combination with concomitant meniscotibial ligament disruption, maldistributed contact forces are placed on the medial compartment, which may result in the progression of osteoarthritis. When facing chronic valgus and/or posteromedial instability, definitive treatment with medial ligament complex reconstruction in combination with additional repair of the meniscotibial ligament when necessary should be done to anatomically restore proper knee biomechanics and kinematics. This technique describes reconstruction of both the superficial medial collateral ligament (sMCL) and posterior oblique ligament with a single allograft, with additional suture tape augmentation used to reinforce the sMCL. Additionally, less invasive onlay fixation is used via a knotless loop mechanism to secure the posterior oblique ligament to its tibial insertion and the sMCL at 2 points along its distal tibial insertion.
膝关节内侧复合体损伤可能导致持续的外翻和旋转不稳定。与半月板胫骨韧带断裂同时存在时，内侧关节间隙会承受分布不均的接触力，这可能导致骨关节炎的进展。面对慢性外翻和/或后内侧不稳定时，应进行内侧韧带复合体重建，并在必要时对半月板胫骨韧带进行额外修复，以从解剖学上恢复膝关节正常的生物力学和运动学。本技术描述了使用单一同种异体移植物重建浅层内侧副韧带（sMCL）和后斜韧带，并使用额外的缝线带增强来加固sMCL。此外，通过无结环机制采用侵入性较小的覆盖固定，将后斜韧带固定于其胫骨附着点，并在sMCL胫骨远端附着点的两个位置进行固定。
