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采用胫骨近端斜行截骨并外侧关节外肌腱固定术的单阶段一期前交叉韧带重建术

Single-Stage Primary Anterior Cruciate Ligament Reconstruction With Slope-Reducing Anterior Closing-Wedge Proximal Tibial Osteotomy and a Lateral Extra-Articular Tenodesis.

作者信息

Shoemaker Evan P, Tollefson Luke V, Lee Dustin R, Rasmussen Matthew T, LaPrade Robert F

机构信息

Twin Cities Orthopedics, Edina, Minnesota, U.S.A.

出版信息

Arthrosc Tech. 2025 Jun 4;14(8):103674. doi: 10.1016/j.eats.2025.103674. eCollection 2025 Aug.

DOI:10.1016/j.eats.2025.103674
PMID:40936544
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12420602/
Abstract

Anterior cruciate ligament (ACL) tears with known risk factors for anterior cruciate ligament reconstruction (ACLR) graft failure, such as elevated posterior tibial slope ≥12°, require a comprehensive treatment approach. In primary ACLRs, slope-reducing anterior closing-wedge proximal tibial osteotomies are not frequently necessary; however, when slope is severely increased (>18°), they should be considered. This Technical Note describes a single-stage combined primary ACLR, anterior closing-wedge proximal tibial osteotomy, and lateral extra-articular tenodesis in a patient with a chronic ACL tear with increased posterior tibial slope.

摘要

对于存在前交叉韧带重建（ACLR）移植物失败已知风险因素的前交叉韧带（ACL）撕裂，如后胫骨坡度≥12°升高，需要综合治疗方法。在初次ACLR中，通常不需要进行减少坡度的前闭合楔形胫骨近端截骨术；然而，当坡度严重增加（>18°）时，应予以考虑。本技术说明描述了一名患有慢性ACL撕裂且后胫骨坡度增加的患者进行的单阶段联合初次ACLR、前闭合楔形胫骨近端截骨术和外侧关节外肌腱固定术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e77d/12420602/1cf63dd17dfe/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e77d/12420602/40e1436f5758/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e77d/12420602/a4c735cf0377/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e77d/12420602/6cd93c2049a8/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e77d/12420602/a58b672fb33f/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e77d/12420602/1cf63dd17dfe/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e77d/12420602/40e1436f5758/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e77d/12420602/a4c735cf0377/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e77d/12420602/6cd93c2049a8/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e77d/12420602/a58b672fb33f/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e77d/12420602/1cf63dd17dfe/gr5.jpg

相似文献

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Single-Stage Primary Anterior Cruciate Ligament Reconstruction With Slope-Reducing Anterior Closing-Wedge Proximal Tibial Osteotomy and a Lateral Extra-Articular Tenodesis.采用胫骨近端斜行截骨并外侧关节外肌腱固定术的单阶段一期前交叉韧带重建术
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本文引用的文献

1
Comparing Postoperative Outcomes of Isolated Anterior Cruciate Ligament Reconstruction and the "Terrible Triad" Anterior Cruciate Ligament Reconstruction With Medial Meniscus Ramp and Lateral Meniscus Root Repairs.比较单纯前交叉韧带重建与“可怕三联征”前交叉韧带重建（联合内侧半月板斜坡和外侧半月板根部修复）的术后结果。
Orthop J Sports Med. 2024 Dec 20;12(12):23259671241303178. doi: 10.1177/23259671241303178. eCollection 2024 Dec.
2
Slope-Reducing Proximal Tibial Osteotomy Improves Outcomes in Anterior Cruciate Ligament Reconstruction Patients With Elevated Posterior Tibial Slope, Especially Revisions and Posterior Tibial Slope ≥12.胫骨近端斜行截骨术可改善后胫骨坡度升高的前交叉韧带重建患者的预后，尤其是翻修手术患者以及后胫骨坡度≥12的患者。
Arthroscopy. 2025 Aug;41(8):3184-3195. doi: 10.1016/j.arthro.2024.10.048. Epub 2024 Nov 12.
3
Anatomic Anterolateral Ligament Reconstruction with Iliotibial Band Graft and Concomitant Anterior Cruciate Ligament Reconstruction.采用髂胫束移植物进行解剖学前外侧韧带重建及同期前交叉韧带重建
Arthrosc Tech. 2024 Feb 2;13(4):102906. doi: 10.1016/j.eats.2023.102906. eCollection 2024 Apr.
4
Ramp lesion in anterior cruciate ligament injury: a review of the anatomy, biomechanics, epidemiology, and diagnosis.前交叉韧带损伤中的斜坡损伤：解剖学、生物力学、流行病学及诊断综述
Knee Surg Relat Res. 2023 Aug 25;35(1):23. doi: 10.1186/s43019-023-00197-z.
5
Elevated Posterior Tibial Slope Is Associated With Anterior Cruciate Ligament Reconstruction Failures: A Systematic Review and Meta-analysis.胫骨后倾角度增加与前交叉韧带重建失败相关：一项系统评价和Meta分析
Arthroscopy. 2023 May;39(5):1299-1309.e6. doi: 10.1016/j.arthro.2022.12.034. Epub 2023 Jan 21.
6
Closing-Wedge Posterior Tibial Slope-Reducing Osteotomy in Complex Revision ACL Reconstruction.复杂翻修性前交叉韧带重建术中的闭合楔形胫骨后倾截骨术
Orthop J Sports Med. 2023 Jan 11;11(1):23259671221144786. doi: 10.1177/23259671221144786. eCollection 2023 Jan.
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Orthop J Sports Med. 2022 Apr 7;10(4):23259671221079380. doi: 10.1177/23259671221079380. eCollection 2022 Apr.
8
Determining the Ratio of Wedge Height to Degree of Correction for Anterior Tibial Closing Wedge Osteotomies for Excessive Posterior Tibial Slope.确定前胫骨闭合楔形截骨术治疗胫骨后倾过多时楔形高度与矫正程度的比值。
Am J Sports Med. 2021 Nov;49(13):3519-3527. doi: 10.1177/03635465211044136. Epub 2021 Sep 30.
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Increased posterior tibial slope results in increased incidence of posterior lateral meniscal root tears in ACL reconstruction patients.胫骨后倾角增加会导致 ACL 重建患者后外侧半月板后根撕裂的发生率增加。
Knee Surg Sports Traumatol Arthrosc. 2021 Nov;29(11):3883-3891. doi: 10.1007/s00167-021-06456-4. Epub 2021 Feb 1.
10
Increased Radiographic Posterior Tibial Slope Is Associated With Subsequent Injury Following Revision Anterior Cruciate Ligament Reconstruction.影像学显示的胫骨后倾增加与前交叉韧带重建翻修术后的后续损伤相关。
Orthop J Sports Med. 2019 Nov 5;7(11):2325967119879373. doi: 10.1177/2325967119879373. eCollection 2019 Nov.