Combined over-the-top reconstruction with posterolateral bundle remnant re-tensioning in pediatric anterior cruciate ligament reconstruction: A technical note

Goki Kamei , Kyohei Nakata , Akinori Nekomoto , Naofumi Hashiguchi , Shunya Tsuji , Masakazu Ishikawa , Atsuo Nakamae , Nobuo Adachi
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Abstract

Epiphyseal injury, particular on femoral side, is a major concern in pediatric anterior cruciate ligament (ACL) reconstruction. Therefore, the over-the-top route (OTTR) method has frequently been selected in pediatric ACL reconstruction, with good clinical results reported. However, a cadaver study reported the inferior rotational stability of the OTTR method to that of anatomical single bundle reconstruction. In recent years, a new method of reconstruction, which involves the remnant being detached, re-tensioned, and re-attached, achieved good short-term results. We developed a surgical method to restore the remnant to the posterolateral (PL) bundle footprint and obtain rotational stability in patients, thereby preserving the remnant. We hypothesized that repairing the residual remnant to the PL bundle footprint in pediatric ACL reconstruction could achieve rotational stability. This report offers the surgical techniques for PL bundle tensioning repair using remnants in the pediatric ACL OTTR procedure.

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小儿前交叉韧带重建中的联合顶部重建与后外侧残余束再张力:技术说明
骨骺损伤,尤其是股骨侧骨骺损伤,是小儿前交叉韧带(ACL)重建术中的一个主要问题。因此,在小儿前交叉韧带重建中,人们经常选择顶部路径(OTTR)方法,并取得了良好的临床效果。然而,一项尸体研究报告称,OTTR 法的旋转稳定性不如解剖单束重建法。近年来,一种新的重建方法取得了良好的短期效果,这种方法是将残余部分分离、重新拉紧并重新连接。我们开发了一种手术方法,可将残余肌束恢复到后外侧(PL)肌束足迹,并获得患者的旋转稳定性,从而保留残余肌束。我们假设,在小儿前交叉韧带重建术中,将残余韧带修复到后外侧韧带束足底可获得旋转稳定性。本报告介绍了在小儿前交叉韧带 OTTR 手术中使用残余物进行 PL 束张力修复的手术技巧。
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来源期刊
CiteScore
3.80
自引率
0.00%
发文量
21
审稿时长
98 days
期刊介绍: The Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology (AP-SMART) is the official peer-reviewed, open access journal of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS) and the Japanese Orthopaedic Society of Knee, Arthroscopy and Sports Medicine (JOSKAS). It is published quarterly, in January, April, July and October, by Elsevier. The mission of AP-SMART is to inspire clinicians, practitioners, scientists and engineers to work towards a common goal to improve quality of life in the international community. The Journal publishes original research, reviews, editorials, perspectives, and letters to the Editor. Multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines will be the trend in the coming decades. AP-SMART provides a platform for the exchange of new clinical and scientific information in the most precise and expeditious way to achieve timely dissemination of information and cross-fertilization of ideas.
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