前交叉韧带联合后外侧角重建1例

Pub Date : 2023-10-28 DOI:10.1016/j.ijso.2023.100706
Hoc Nguyen Van, Khanh Nguyen Manh
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引用次数: 0

摘要

复合后外侧角(PLC)-前交叉韧带(ACL)撕裂占复杂膝关节损伤的10%。在ACL-PLL损伤的膝关节中,未经治疗的PLC损伤会导致ACL移植物上的力显著增加,可能是移植物失败的主要原因。病例介绍:一名26岁男性患者,合并ACL和PLC损伤。他同时进行了ACL和PLC的重建。我们使用了2个半腱肌(每个膝盖1个)和1个冰川肌腱(受伤的膝盖)。前交叉韧带由一只4股的猴用全内固定技术和TightRope固定重建。PLC重建利用等轴测点处的一个股骨隧道,通过TightRope在股骨隧道处进行移植物固定,并通过可吸收螺钉在胫骨隧道处进行移植固定。经过9个月的随访,辛辛那提的评分为70/100,IKDC评分为B型。讨论与以前的方法相比,主要优点是外科医生不必关心肌腱长度和移植物直径。结论ACL和PLC联合重建能较好地保留膝关节功能,减少ACL重建失败。然而,股骨隧道的创建需要小心,以避免股骨隧道交叉。
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Concomitantly combined anterior cruciate ligament and posterolateral corner reconstruction: A case report

Introduction

Combined posterolateral corner (PLC) - anterior cruciate ligament (ACL) tears account for 10% of complex knee injuries. In an ACL-PLC injured knee, an untreated PLC injury causes a significant increase in force on the ACL graft and may be a leading cause of graft failure.

Case presentation

A 26-year-old male patient with combined ACL and PLC injury. He was concurrently reconstructed in both ACL and PLC. We used 2 semitendinosus (1 in each knee) and 1 glacilis tendon (in the injured knee). The ACL was reconstructed by one 4-stranded simitendinosus with an all-inside technique and TightRope fixation. The PLC reconstruction utilized one femoral tunnel at the isometric point, graft fixation at the femoral tunnel by TightRope, and at the tibial tunnel by absorbable screw. After a follow-up of 9 months, Cincinnati's score was 70/100 and the IKDC score was B type.

Discussion

The main advantage is that surgeons do not have to care about tendon length and graft diameter compared to the previous method.

Conclusion

Concomitantly combined ACL and PLC reconstruction has good results in remaining knee functions and decreasing ACL reconstruction failure. However, femoral tunnel creation needs to be careful to avoid femoral tunnel intersections.

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