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[前交叉韧带断裂:重建时必须牢记什么?]

[Rupture of the anterior cruciate ligament : What must be born in mind in the reconstruction?].

作者信息

Fink Christian, Marchetti Andrea, Schwäblein Tobias, Herbort Mirco

机构信息

Gelenkpunkt - Sport und Gelenkchirurgie, Olympiastraße 39, 6020, Innsbruck, Österreich.

Research Unit für Sportmedizin des Bewegungsapparates und Verletzungsprävention, UMIT, Hall, Österreich.

出版信息

Unfallchirurgie (Heidelb). 2025 Apr;128(4):297-308. doi: 10.1007/s00113-025-01551-4. Epub 2025 Mar 19.

Abstract

Rupture of the anterior cruciate ligament (ACL) is a common sports injury. Despite continuous improvements over the years, not all patients return to their preoperative activities after treatment of the ACL. Therefore, individualized treatment approaches based on transplant selection, reconstruction technique and biomechanical factors, such as the tibial slope and rotational instability are crucial. Autogenous transplants have different properties in terms of donor site morbidity, healing behavior and risk of rerupture. The individual needs of the patient should therefore be taken into consideration. In terms of the surgical technique, correct tunnel placement based on anatomical landmarks is essential. In addition, concomitant instabilities and meniscus injuries must be addressed. In the event of a rerupture, an exact analysis of the causes is necessary. Ultimately, the success of the treatment depends to a large extent on precise diagnostics and the treatment of both the ACL rupture and any injured accompanying structures.

摘要

前交叉韧带(ACL)断裂是一种常见的运动损伤。尽管多年来不断改进,但并非所有患者在ACL治疗后都能恢复到术前的活动水平。因此,基于移植物选择、重建技术和生物力学因素(如胫骨坡度和旋转不稳定)的个体化治疗方法至关重要。自体移植物在供区发病率、愈合行为和再断裂风险方面具有不同的特性。因此,应考虑患者的个体需求。在手术技术方面,基于解剖标志正确放置隧道至关重要。此外,必须处理合并存在的不稳定和半月板损伤。如果发生再断裂,有必要对原因进行精确分析。最终,治疗的成功在很大程度上取决于精确的诊断以及对ACL断裂和任何伴随损伤结构的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b040/11933175/1c54f6064640/113_2025_1551_Fig1_HTML.jpg

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