外侧关节外肌腱固定术的禁忌证：一项系统综述
简介
一项系统综述纳入2012至2024年间14篇I-III级证据研究，评估前交叉韧带重建（ACLR）联合外侧关节外肌腱固定术（LET）的禁忌症。关键发现：关节软骨损伤及合并其他膝关节韧带损伤（除ACL外）是最常提及的禁忌症，但多数研究为回顾性（8篇）且证据等级偏低（9篇III级）。临床意义：目前LET禁忌症尚不明确，关节软骨损伤和合并韧带损伤是相对明确的考量因素…
英文摘要
Background: Lateral extra-articular tenodesis (LET) is a surgical procedure that is additionally implemented in concurrent anterior cruciate ligament reconstruction (ACLR). Although numerous articles have addressed the use of LET in conjunction with ACLR, few definitive contraindications were identified. Given the scarcity of literature evaluating contraindications for LET modality, this study aimed to systematically review the reported contraindications of this procedure in the context of concurrent ACLR. Methods: The searched key terms: (extra-articular OR extraarticular) AND (tenodesis OR plasty OR augmentation OR procedure or reconstruction OR reconstructive OR surgical OR surgery OR technique) AND (ACL OR anterior cruciate ligament), with no publication date restrictions in PubMed, ScienceDirect, Cochrane Central, Web of Science, and Embase databases. We included clinical human studies, with levels of evidence I-III and in the English language. Results: The analysis evaluated fourteen articles published between 2012 and 2024. Level III evidence was found in the majority of studies (n = 9) and Level I evidence was found in the rest (n = 5). The majority of the included articles were retrospective (n = 8) and there were also prospective studies (n = 6). The articles reviewed showed that articular cartilage damage and concomitant injuries to other knee ligaments, alongside ACL injury, are the most frequently mentioned. Conclusions: This is the first study that systematized the contraindications for the LET procedure in ACLR. The contraindications remain unclear; however, the following may be highlighted: articular cartilage damage and injury to another ligament in the knee, in addition to ACL injury.