单束ACL重建联合LET或双束ACL重建可考虑用于高风险轴移膝：一项尸体生物力学研究
简介
10例尸体下肢生物力学研究比较完整膝、ACL缺失+半月板切开、DB ACLR、SB ACLR及SB ACLR+LET五种状态。DB、SB和SB+LET均显著减少Lachman试验胫骨前移，但仅DB和SB+LET显著改善轴移试验旋转稳定性，单独SB无显著改善。对高风险轴移膝，SB ACLR+LET或DB ACLR或可考虑。
英文摘要
Lateral extra-articular tenodesis (LET) has been re-evaluated, and double-bundle (DB) anterior cruciate ligament reconstruction (ACLR) has also been used to provide greater rotational stability. The purpose of this study is to quantitatively compare the effects of single-bundle (SB) ACLR with LET and DB ACLR on knee joint stability in high-risk pivot-shift knees. Ten fresh-frozen cadaveric whole lower limbs were used under five conditions: (A) intact knee, (B) ACL-deficient knee with meniscal cut, (C) DB ACLR, (D) SB ACLR, and (E) SB ACLR with LET. Anterior tibial translation (ATT) during the Lachman test and posterior tibial acceleration (PTA) during the pivot-shift test were measured using an electromagnetic measurement system. ATT differed significantly among conditions (p < 0.01): (A) 6.8 ± 1.8 mm; (B) 13.3 ± 2.1 mm; (C) 7.6 ± 1.5 mm; (D) 8.0 ± 1.0 mm; and (E) 7.7 ± 1.1 mm (mean ± SD). (C), (D), and (E) significantly reduced ATT compared to (B) (p < 0.01). PTA differed significantly among conditions (p < 0.01): (A) 1.4 ± 1.2 m/s2; (B) 2.5 ± 1.0 m/s2; (C) 1.3 ± 0.9 m/s2; (D) 1.9 ± 1.2 m/s2; and (E) 1.4 ± 0.7 m/s2. (C) and (E) showed significantly improved rotational stability compared to (B) (p < 0.01 and p < 0.01), whereas (D) did not show a significant difference. SB ACLR alone did not significantly improve rotational stability. In cases with residual pivot-shift risk, either SB ACLR with LET or DB ACLR may be reasonable surgical options.