• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验

使用快速固化骨移植替代物实现单阶段翻修前交叉韧带重建

Use of Fast-Setting Bone Graft Substitute to Allow Single-Stage Revision Anterior Cruciate Ligament Reconstruction.

作者信息

Khan Shehzaad A, Stephens Alastair, Spalding Tim, Thompson Peter

机构信息

Trauma and Orthopaedics, University Hospital Coventry and Warwickshire NHS Trust, Coventry, United Kingdom.

Cleveland Clinic London, London, United Kingdom.

出版信息

Video J Sports Med. 2024 Oct 16;4(5):26350254241263973. doi: 10.1177/26350254241263973. eCollection 2024 Sep-Oct.

DOI:10.1177/26350254241263973
PMID:40309243
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11752174/
Abstract

BACKGROUND

The overall revision rate for primary anterior cruciate ligament reconstruction (ACLR) has increased over the past decade, with the commonest mode of failure being a combination of traumatic, technical, and biological factors. The challenge in revision ACLR is the need to address malpositioned or widened tunnels with the ideal scenario being single-stage revision, with widened and type 2 tunnels being the most difficult scenarios to deal with. Tunnels can be filled using autograft, allograft, and more recently described bone graft substitute (BGS). In this video, we describe a technique using fast-setting BGS to fill the problem of malpositioned tunnel or tunnels to allow single-stage revision ACLR.

INDICATIONS

This technique is indicated in patients undergoing revision ACLR where tunnels are nearly right (type 2) with no widening at the joint surface aperture.

TECHNIQUE DESCRIPTION

Following preparation of the notch, the femoral tunnels are prepared in the normal fashion to remove all the previous graft and to create fresh bleeding surfaces. The fluid in the knee is completely drained, and the femoral tunnel is repeatedly dried with ribbon gauze that is left in place until ready to inject. The BGS, genex (Biocomposites Ltd), is mixed and loaded into the delivery syringe before injecting arthroscopically. After 15 minutes, the new anatomic femoral tunnel is then prepared in routine fashion. The same steps are repeated for the tibial tunnel.

RESULTS

Twenty patients underwent single-stage revision ACLR using this technique. There have been no reruptures in this series. All eligible patients at the 12-month follow-up had grade 0 or 1 laxity on clinical examination and full incorporation of the BGS on radiographs. There were no complications related to the BGS during the intra- or postoperative period.

DISCUSSION/CONCLUSION: We describe a technique that allows revision ACLR to be performed as single stage in a subset of patients with type 2 tunnels with successful short- to mid-term results. We have found this to be a safe and effective way to avoid 2-stage surgery in a subgroup of cases who have a challenging problem for surgeons to manage.

PATIENT CONSENT DISCLOSURE STATEMENT

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.

摘要

背景

在过去十年中,初次前交叉韧带重建术(ACLR)的总体翻修率有所上升,最常见的失败模式是创伤、技术和生物学因素的综合作用。翻修ACLR面临的挑战是需要处理位置不当或变宽的隧道,理想情况是一期翻修,而变宽的2型隧道是最难处理的情况。隧道可以使用自体移植物、同种异体移植物以及最近描述的骨移植替代物(BGS)进行填充。在本视频中,我们描述了一种使用快速凝固BGS来解决位置不当的隧道问题,从而实现一期翻修ACLR的技术。

适应症

该技术适用于接受ACLR翻修的患者,其隧道接近正常(2型),关节面开口处无增宽。

技术描述

在准备好髁间窝后,以常规方式准备股骨隧道,以清除所有先前的移植物并创建新鲜的出血表面。膝关节内的液体完全排出,股骨隧道用带状纱布反复干燥,纱布留在原位直至准备注射。将BGS(genex,Biocomposites Ltd)混合并装入输送注射器,然后进行关节镜注射。15分钟后,再以常规方式准备新的解剖学股骨隧道。胫骨隧道重复相同步骤。

结果

20例患者使用该技术进行了一期ACLR翻修。该系列中没有再次断裂的情况。在12个月随访时,所有符合条件的患者临床检查时松弛度为0级或1级,X线片显示BGS完全融合。术中或术后期间没有与BGS相关的并发症。

讨论/结论:我们描述了一种技术,该技术可使一部分2型隧道患者的ACLR翻修手术一期完成,短期至中期结果成功。我们发现这是一种安全有效的方法,可避免在一部分对外科医生来说具有挑战性的病例中进行二期手术。

患者同意披露声明

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,作者已随本提交的出版物附上患者的豁免声明或其他书面批准形式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/412c/11752174/b77bcaa91375/10.1177_26350254241263973-img2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/412c/11752174/b77bcaa91375/10.1177_26350254241263973-img2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/412c/11752174/b77bcaa91375/10.1177_26350254241263973-img2.jpg

相似文献

1
Use of Fast-Setting Bone Graft Substitute to Allow Single-Stage Revision Anterior Cruciate Ligament Reconstruction.使用快速固化骨移植替代物实现单阶段翻修前交叉韧带重建
Video J Sports Med. 2024 Oct 16;4(5):26350254241263973. doi: 10.1177/26350254241263973. eCollection 2024 Sep-Oct.
2
Hybrid Bone-Grafting Technique for Staged Revision Anterior Cruciate Ligament Reconstruction.分期翻修前交叉韧带重建的混合骨移植技术
JBJS Essent Surg Tech. 2021 Oct 12;11(4). doi: 10.2106/JBJS.ST.20.00055. eCollection 2021 Oct-Dec.
3
Stage I Revision ACL Reconstruction With Allograft Bone Dowels.采用同种异体骨栓进行一期翻修前交叉韧带重建术。
Video J Sports Med. 2024 Jun 18;4(3):26350254241229099. doi: 10.1177/26350254241229099. eCollection 2024 May-Jun.
4
Tips and Tricks for Anatomic ACL Reconstruction With Soft-Tissue Quadriceps Tendon and Remnant Repair.使用软组织股四头肌肌腱和残端修复进行解剖学前交叉韧带重建的技巧与窍门。
Video J Sports Med. 2023 Sep 11;3(5):26350254231156238. doi: 10.1177/26350254231156238. eCollection 2023 Sep-Oct.
5
Reliable Anatomic Femoral Tunnel Positioning for Anterior Cruciate Ligament Reconstruction Using a Novel Femoral Aiming Guide.使用新型股骨瞄准器进行前交叉韧带重建时可靠的解剖学股骨隧道定位
Video J Sports Med. 2024 Sep 4;4(5):26350254241233595. doi: 10.1177/26350254241233595. eCollection 2024 Sep-Oct.
6
Two-Stage Revision ACL Reconstruction with Arthroscopic Tunnel Bone Grafting.关节镜下隧道植骨两阶段翻修前交叉韧带重建术
Video J Sports Med. 2023 Oct 27;3(5):26350254231209333. doi: 10.1177/26350254231209333. eCollection 2023 Sep-Oct.
7
Clinical Outcomes of Single-Stage Revision Anterior Cruciate Ligament Reconstruction Using a Fast-Setting Bone Graft Substitute.使用快速凝固骨替代物进行单阶段翻修前交叉韧带重建的临床结果。
J Knee Surg. 2024 Jun;37(7):505-511. doi: 10.1055/s-0043-1777053. Epub 2023 Dec 4.
8
Femoral-Physeal-Sparing ACL Reconstruction With Lateral Extra-articular Tenodesis and Inside-Out Repair of Lateral Meniscus in a Skeletally Immature Patient.在一名骨骼未成熟患者中采用保留股骨骨骺的前交叉韧带重建术联合外侧关节外腱固定术及外侧半月板由外向内修复术
Video J Sports Med. 2023 May 16;3(3):26350254231163594. doi: 10.1177/26350254231163594. eCollection 2023 May-Jun.
9
Allogenous Bone Grafting Technique for Staged Revision Anterior Cruciate Ligament Surgery.分期翻修前交叉韧带手术的同种异体骨移植技术
Video J Sports Med. 2023 Sep 28;3(5):26350254231200038. doi: 10.1177/26350254231200038. eCollection 2023 Sep-Oct.
10
Influence of Preoperative Tunnel Widening On the Outcomes of a Single Stage-Only Approach to Every Revision Anterior Cruciate Ligament Reconstruction: An Analysis of 409 Consecutive Patients From the SANTI Study Group.单阶段翻修术治疗前交叉韧带重建术后翻修的疗效:SANTI 研究组 409 例连续患者的分析结果 术前隧道增宽的影响
Am J Sports Med. 2021 May;49(6):1431-1440. doi: 10.1177/0363546521996389. Epub 2021 Mar 10.

本文引用的文献

1
Single-Stage Revision Anterior Cruciate Ligament Reconstruction: Experience With 91 Patients (40 Elite Athletes) Using an Algorithm.单阶段翻修前交叉韧带重建:使用算法的 91 例患者(40 名精英运动员)的经验。
Am J Sports Med. 2021 Feb;49(2):364-373. doi: 10.1177/0363546520976633. Epub 2020 Dec 17.
2
Single-Stage Revision Anterior Cruciate Ligament Reconstruction Using Fast-Setting Bone Graft Substitutes.使用快速凝固骨移植替代物的单阶段翻修前交叉韧带重建术。
Arthrosc Tech. 2020 Jan 28;9(2):e225-e231. doi: 10.1016/j.eats.2019.10.002. eCollection 2020 Feb.
3
Arthroscopic Delivery of Injectable Bone Graft for Staged Revision Anterior Cruciate Ligament Reconstruction.
关节镜下注射式骨移植用于分期翻修前交叉韧带重建术
Arthrosc Tech. 2017 Nov 20;6(6):e2223-e2227. doi: 10.1016/j.eats.2017.08.025. eCollection 2017 Dec.
4
Outcomes After 1-Stage Versus 2-Stage Revision Anterior Cruciate Ligament Reconstruction.一期与二期翻修前交叉韧带重建后的结果
Am J Sports Med. 2017 Jul;45(8):1790-1798. doi: 10.1177/0363546517698684. Epub 2017 Apr 18.
5
Revision Anterior Cruciate Ligament Reconstruction: Results of a Single-stage Approach Using Allograft Dowel Bone Grafting for Femoral Defects.前交叉韧带重建翻修术:采用同种异体骨栓植骨治疗股骨缺损的单阶段手术结果
J Am Acad Orthop Surg. 2016 Aug;24(8):581-7. doi: 10.5435/JAAOS-D-15-00572.
6
Two-Stage Revision Anterior Cruciate Ligament Reconstruction.两阶段翻修前交叉韧带重建术
Orthopedics. 2016 May 1;39(3):e456-64. doi: 10.3928/01477447-20160324-01. Epub 2016 Apr 5.
7
Bone grafts, bone substitutes and orthobiologics: the bridge between basic science and clinical advancements in fracture healing.骨移植材料、骨替代物和骨生物制剂:基础科学与骨折愈合临床进展之间的桥梁。
Organogenesis. 2012 Oct-Dec;8(4):114-24. doi: 10.4161/org.23306. Epub 2012 Oct 1.
8
Bone healing response to a synthetic calcium sulfate/β-tricalcium phosphate graft material in a sheep vertebral body defect model.绵羊椎体缺损模型中合成硫酸钙/β-磷酸三钙移植物的骨愈合反应。
J Biomed Mater Res B Appl Biomater. 2012 Oct;100(7):1911-21. doi: 10.1002/jbm.b.32758. Epub 2012 Jul 30.
9
Outcome of revision anterior cruciate ligament reconstruction: a systematic review.前交叉韧带重建翻修术的结果:系统评价。
J Bone Joint Surg Am. 2012 Mar 21;94(6):531-6. doi: 10.2106/JBJS.K.00733.
10
Current trends and future perspectives of bone substitute materials - from space holders to innovative biomaterials.当前骨替代材料的趋势和未来展望——从空间占位到创新生物材料。
J Craniomaxillofac Surg. 2012 Dec;40(8):706-18. doi: 10.1016/j.jcms.2012.01.002. Epub 2012 Jan 31.