内侧副韧带合并前交叉韧带损伤的临床治疗策略

Clinical therapeutic strategy for injuries of the medial collateral ligament and anterior cruciate ligament

膝关节内侧副韧带Hughston Ⅲ级损伤常合并有前交叉韧带损伤,韧带重建术是目前该类损伤主要的治疗方式。其中,前交叉韧带重建术已经从传统的等长重建发展到解剖重建,使膝关节术后的前后稳定性和患者的运动水平得到了更满意的临床效果;目前内侧副韧带的重建方式较多,但是大多不能很好的恢复膝关节的旋转稳定性,内侧副韧带三角矢量重建在恢复膝关节外翻稳定性的同时,能够有效的恢复旋转稳定性。对于合并有内侧副韧带和前交叉韧带的损伤,二者造成旋转稳定性的叠加损失,内侧副韧带三角矢量重建发挥的作用就显得更加重要。作者提出了一种治疗内侧副韧带和前交叉韧带合并损伤的临床治疗策略,旨在更好地指导、应用于临床。

The Hughston grade III medial collateral ligament （MCL） injury is often complicated by the anterior eruciate ligament （ACL） injury, and currently, ligament reconstruction is the major treatment modality for such injuries. The ACL reconstruction has evolved from isometric reconstruction to anatomical reconstruction which can achieve satisfactory effects in the stability of the anterior-posterior direction of knee joint and patients＇ movement level. At present, there are many methods for MCL reconstruction, but most of them cannot restore the rotational stability of knee joint. The triangular vector reconstruction of the MLC can restore the valgus stability and rotational stability of knee joint. The combined MCL and ACL injuries can cause reduced rotational stability, and therefore, the triangular vector reconstruction of the MLCis more important. In this article, we put forward a clinical therapeutic strategy for the treatment of combined MCL and ACL injuries to guide clinical practice.