膝关节前外侧韧带的研究进展

Research progress in anterolateral ligament of knee

目的对膝关节前外侧韧带(anterolateral ligament,ALL)的研究进展进行综述,为临床诊治提供参考。方法广泛查阅近年来国内外有关ALL损伤诊断及治疗的文献,总结膝关节ALL解剖形态、生物力学以及ALL损伤机制、治疗现状。结果膝关节ALL具有限制胫骨内旋及前移作用,影响膝关节轴移。ALL损伤后可结合患者体征和MRI检查诊断。膝关节ALL手术指征尚未统一,但多数学者倾向于对需进行前交叉韧带(anterior cruciate ligament,ACL)重建或翻修且伴有高度轴移试验阳性的患者进行ALL重建。目前ALL重建方式较多,但尚无最佳治疗术式。此外,由于缺乏高质量的术后长期随访研究,远期临床疗效仍不明确。结论ALL在维持膝关节稳定性方面具有一定作用,但ALL重建技术及临床疗效仍待进一步研究。

Objective To review research progress in the anterolateral ligament(ALL)of knee,and provide a clinical reference for diagnosis and treatment of ALL injury.Methods The literature on the diagnosis and treatment of ALL injury was widely reviewed.The incidence,anatomy,biomechanics,injury mechanism,and treatment status of ALL were summarized.Results The ALL contributes to the effect of controlling the internal rotation and anterior translation of the tibia,which affects the axial migration of the knee.ALL injury can be diagnosed according to the signs and MRI examination.Currently,no consensus exists for the surgical indications of ALL injury,but most surgeons tend to perform ALL reconstruction in patients requiring anterior cruciate ligament(ACL)reconstruction or revision surgery with higher pivot-shift tests.At present,various techniques have been used for ALL reconstruction,and there is no optimal technique.In addition,the long-term effectiveness of ALL reconstruction is unclear due to the lack of high-quality studies and longterm postoperative follow-up.Conclusion The ALL contributes to maintaining knee stability,and the ALL reconstruction technique and its effectiveness still need further research.