在前十字带重建后,旋转不稳定的管理
Dileepa Banagala1, Ying Ren Mok1, Jhulia Kawachi Cruz1
1Department of Orthopaedic Surgery, National University Hospital, Singapore.
Video journal of sports medicine
|December 15, 2025
概括
在ACL重建后的垂直股骨道可以导致旋转不稳定. 这篇论文详细介绍了如何管理这一点,通过在修复ACL重建加上横向外关节延展 (LET) 或基于患者活动水平的隔离LET之间进行选择.
科学领域:
- 整形外科手术 整形外科手术
- 运动医学 运动医学
- 膝盖生物力学 膝盖生物力学
背景情况:
- 腿部道不良位置是ACL移植失败的主要原因 (63%).
- 垂直股骨道可以导致持续的旋转不稳定,尽管ACL移植完好无损.
- 跨骨技术往往导致子最佳的移植位置,导致膝盖的不稳定.
研究的目的:
- 为了说明垂直ACL移植患者的旋转不稳定性管理.
- 为了指导针对特定患者的个人资料,在修复ACL重建 (ACLR) 加上侧向外关节延展 (LET) 和隔离LET之间进行手术决策.
- 为突出患者的治疗策略垂直ACL移植和中间阴茎桶手柄撕裂的患者.
主要方法:
- 基于案例的技术论文讨论了两个不同的患者场景.
- 根据患者的症状,活动水平和阴茎病理学量身定制的管理.
- 涉及评估修订ACLR和/或LET的选项.
主要成果:
- 一个需要较少的患者,有完整的ACL移植和半径撕裂,接受了中间半径修复和LET治疗,改善了旋转稳定性.
- 一个高度活跃的患者,有完整的ACL移植和半径撕裂,经历了修改ACLR,半径修复和LET持续不稳定.
- 这两种情况都涉及在垂直ACL移植的设置中解决中间阴茎水桶手柄撕裂.
结论:
- 垂直ACL移植可能会恢复前后部的稳定性,但可能会导致长期的旋转不稳定性.
- 结合LET和ACL修改,有利于持续不稳定的高需求患者.
- 单独的LET对具有完整移植的低需求患者有效,改善功能并恢复运动准备.
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