外侧关节外肌腱固定术（LET）在前交叉韧带损伤运动员中的作用
简介
这篇综述聚焦于外侧关节外肌腱固定术（LET）作为ACL重建辅助术式在高水平运动员中的应用价值。生物力学与临床证据显示，LET可增强前向和旋转稳定性，降低移植物受力与失败率，且不增加外侧间室关节炎风险，有助于提高重返运动率。对于存在高度再损伤风险的运动员，LET是值得考虑的辅助选择，但需严格把握适应证并关注外侧膝痛等并发症。
英文摘要
Lateral extra-articular tenodesis (LET) has re-emerged as a significant adjunct to anterior cruciate ligament reconstruction (ACLR), particularly in high-level athletes who are at a heightened risk for re-injury and graft failure. This review synthesizes recent literature examining the biomechanical and clinical outcomes associated with LET in the context of ACLR in high-level athletes. Biomechanical studies indicate that LET can enhance knee stability by providing additional restraint against anterior tibial translation and rotatory instability, thereby reducing rotational laxity and offloading stress on the intra-articular graft. Cadaveric and in vivo studies suggest that LET can reduce forces applied to the graft and improve knee kinematics, particularly in the setting of concomitant injury to the anterolateral complex. Furthermore, recent clinical research has shown that incorporating LET during ACLR surgery is associated with lower rates of graft failure and improved functional outcomes, including high rates of return to pre-injury level of sport among high-level athletes. However, the literature also highlights the need for careful patient selection and consideration of potential implant-related complications, as well as the risk of lateral knee pain. Recent evidence indicates that LET does not increase the risk of lateral compartment osteoarthritis when modern surgical techniques and appropriate graft tensioning are employed. Overall, while LET shows promise in improving the outcomes of ACLR surgery in high-level athletes, further high-quality research is warranted to establish standardized protocols and long-term efficacy.