行前交叉韧带重建联合膝外侧腱固定术时避免股骨隧道汇聚与移植物损伤
简介
针对ACL重建联合外侧关节外腱固定术（LET）时，股骨隧道汇聚可能导致ACL移植物固定失效的并发症，本文介绍了一种改良Lemaire LET手术技巧，通过调整锚钉置入角度与屈膝角度，避免损伤ACL悬吊固定装置。该技术不依赖额外助手，操作简便，可有效降低锚钉-隧道汇聚风险。
英文摘要
Lateral extra-articular tenodesis (LET) procedures have become increasingly popular in recent years as adjuncts to anterior cruciate ligament (ACL) reconstruction. One potential complication of combining LET with ACL reconstruction is tunnel convergence, which can lead to inadvertent loss of femoral ACL graft fixation. While modern LET techniques have incorporated suture anchors to avoid tunnel convergence, there is still a significant risk of anchor-tunnel convergence leading to loss of ACL graft fixation, especially when utilizing suspensory fixation devices and anteromedial portal femoral drilling. Previous techniques have described drill angulation and high knee flexion angles during LET tunnel/anchor placement to avoid this complication but are highly dependent upon user experience or may require additional operating room assistants for leg positioning. We describe our surgical technique to avoid damaging ACL graft suspensory fixation devices when performing ACL reconstruction with a concurrent modified Lemaire LET.