Franciozi Carlos E, Mameri Enzo S, Schumacher Felipe C, Credidio Marcos V, Kubota Marcelo S, Luzo Marcus V
Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
Hospital do Coração, São Paulo, Brazil.
Video J Sports Med. 2023 Nov 6;3(6):26350254231195086. doi: 10.1177/26350254231195086. eCollection 2023 Nov-Dec.
Genu recurvatum is a challenging disorder and can negatively affect knee biomechanics, as reflected in its role as a risk factor for knee ligament injury and poor outcomes following ligament reconstruction or arthroplasty.
Pathological recurvatum should be addressed in the presence of a causative correctible structural abnormality, whether due to decreased posterior tibial slope or due to multiligament injury. We described a posterior oblique ligament (POL) advancement technique for the treatment of knee recurvatum.
After completion of all concomitant procedures such as ligament reconstructions, the procedure is initiated with a medial approach. The POL is isolated with an inverted L-shaped dissection and mobilized. Mattress sutures are passed through the resulting POL flap, and are re-tensioned and fixed anteriorly and distally, with the knee close to extension, in order for the imbrication to restrain hyperextension.
Anecdotal evidence points to satisfactory control of knee recurvatum postoperatively, which can potentially avoid its deleterious effects in surgical outcomes.
DISCUSSION/CONCLUSION: We present a promising option in the treatment of pathological recurvatum, with favorable cost-efficacy, low morbidity relative to slope-altering osteotomy or posterolateral soft tissue procedures, and focused on the biomechanically demonstrated main restrictors to knee hyperextension.
The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
膝反屈是一种具有挑战性的病症，会对膝关节生物力学产生负面影响，这在其作为膝关节韧带损伤的风险因素以及韧带重建或关节置换术后不良预后的作用中得以体现。
当存在可纠正的致病结构异常时，无论该异常是由于胫骨后倾减小还是多韧带损伤导致，均应处理病理性膝反屈。我们描述了一种用于治疗膝反屈的后斜韧带（POL）推进技术。
在完成诸如韧带重建等所有相关手术步骤后，以内侧入路开始该手术。采用倒L形解剖分离并游离POL。褥式缝线穿过由此形成的POL瓣，在膝关节接近伸直位时向前方和远端重新张紧并固定，以使叠瓦状缝合限制膝关节过伸。
轶事证据表明术后膝反屈得到了满意的控制，这有可能避免其对手术结果产生有害影响。
讨论/结论：我们提出了一种治疗病理性膝反屈的有前景的选择，其成本效益良好，相对于改变坡度的截骨术或后外侧软组织手术，发病率较低，并且专注于在生物力学上已证实的膝关节过伸的主要限制因素。
作者证明已获得本出版物中出现的任何患者的同意。如果个体可能被识别，作者已随本投稿包含患者的豁免声明或其他书面批准形式以供发表。
