Canuto Sergio Marinho de Gusmão, Rocha de Faria José Leonardo, de Araújo Igor Farias, Bezerra Pedro Enio Feitosa, da Silva Araújo João Henrique, Ariel de Lima Diego, de Oliveira Diego Escudeiro, Barroso Bernardo Garcia, Canuto Arthur Macedo de Gusmão, Jorge Pedro Baches, de Pádua Vitor Barion Castro, Helito Camilo Partezani
Ortoclínica, Orthopaedics Hospital, Maceió, AL - Brazil.
Knee Surgery Center, National Institute of Traumatology and Orthopedics (INTO), Rio de Janeiro, RJ - Brazil.
Arthrosc Tech. 2025 Jun 13;14(7):103625. doi: 10.1016/j.eats.2025.103625. eCollection 2025 Jul.
This article describes a modification of an surgical technique for the anatomical reconstruction of the superficial medial collateral ligament (MCL) of the knee using a semitendinosus tendon graft in a minimally invasive approach. The MCL often is the site of severe injuries, which can result in long-term complications such as instability. The detailed surgical technique begins with an examination under anesthesia and diagnostic arthroscopy for accurate injury assessment. The semitendinosus tendon is used as a graft and fixed in the tibial communicating tunnels, with interference screw fixation only on the femur, restoring the integrity of the MCL. The postoperative protocol involves a careful rehabilitation process, including weight-bearing restriction and gradual return to sports activities. This technique offers advantages such as increased graft strength and lower surgical morbidity, making it a viable option for patients with anteromedial instabilities and grade III MCL injuries, especially when there are concomitant anterior cruciate ligament injuries. The anatomical reconstruction of the MCL with a double bundle and semitendinosus tendon graft is a promising technique that continues to be refined and studied in the quest for improved long-term outcomes in knee stability.
本文介绍了一种手术技术的改良方法,该方法采用微创入路,使用半腱肌腱移植对膝关节内侧副韧带(MCL)进行解剖重建。MCL常是严重损伤的部位,可能导致长期并发症,如膝关节不稳。详细的手术技术始于麻醉下检查和诊断性关节镜检查,以准确评估损伤情况。使用半腱肌腱作为移植物,并固定于胫骨交通隧道内,仅在股骨侧采用挤压螺钉固定,以恢复MCL的完整性。术后方案包括仔细的康复过程,包括限制负重和逐步恢复体育活动。该技术具有移植物强度增加和手术并发症较低等优点,对于存在前内侧不稳和Ⅲ度MCL损伤的患者,尤其是伴有前交叉韧带损伤的患者,是一种可行的选择。采用双束半腱肌腱移植对MCL进行解剖重建是一种有前景的技术,在追求改善膝关节长期稳定性结果的过程中,该技术仍在不断完善和研究。