膝关节前外侧韧带损伤的诊治进展

Current knowledge in the treatment of anterolateral ligament injury of knees

尽管在前交叉韧带损伤中,前外侧稳定结构的稳定作用许多年前就已被认识到。但大多术者在进行前交叉韧带重建时并没有将前外侧结构考虑进去。虽然对前交韧带进行解剖单束或解剖双束重建可明显提高膝关节的稳定性,但仍有部分患者残留前后和旋转不稳。由此很多学者开始关注前外侧结构,特别是前外侧韧带。目前对在何种情况下需要进行前交叉韧带联合前外侧韧带重建术缺少统一标准,运用何种技术重建也缺乏循证医学支持,期待以后更多随机对照研究来验证。

Although the function of the anterolateral stabilizing structures of the knee in the anterior cruciate ligament（ACL） injuries has been recognized since many years,most of orthopedic surgeons do not take the anterolateral structure into consideration when performing an ACL reconstruction. Anatomic ACL reconstruction will improve knee stability,but a small subset of patients may experience some residual anteroposterior and rotational instability. For this reason,some researchers have paid attention to the anterolateral aspects of the knee,especially the anterolateral ligament. We don ＇t know the best time to perform ACL and ALL reconstruction. And we lack the evidence to prove which technique is the best one. So we look forward to more random controlled trial.