膝关节前外侧结构加强及重建专家共识(2021年版)

Expert consensus on augmentation and reconstruction of anterolateral structure of knee(2021)

膝关节前交叉韧带重建术有一定的失败风险,对于有高危因素的患者,其失败率更高。随着对膝关节前外侧结构在维持膝关节旋转稳定中作用的发现与认知,在前交叉韧带重建的同时可以进行膝关节前外侧结构的加强或重建以降低伴有高危因素的前交叉韧带损伤患者的治疗失败率。因此,专家组在循证医学的基础上,对膝关节前外侧结构的定义、术前评估、手术适应证、手术技术和策略、术后康复及并发症预防与处理原则等方面进行了文献总结和讨论,制定了膝关节前外侧结构加强及重建专家共识规范。本共识将提供一套临床诊疗方法与路径参考,以便医生在为具有较高失效风险患者进行前交叉韧带重建和翻修手术时选择前外侧结构加强或者重建。

Anterior cruciate ligament(ACL)reconstruction of the knee is associated with a certain risk of failure,and the failure rate is higher in high-risk patients.With the discovery and recognition of roles of anterolateral structure(ALS)in maintaining the rotation stability in normal knee,it is possible to augment or reconstruct ALS in combination with ACL reconstruction to reduce the failure rate in the patients with high-risk factors for ACL injuries.Therefore,on the basis of evidence-based medicine,the expert group summarized and discussed literature on the definition,preoperative evaluation,surgical indications,surgical techniques and strategies,principles in postoperative rehabilitation,and prevention and management of complications for the ALS of knee,and developed this consensus.The proposed consensus will provide physicians with a complete set of clinical routines and pathways for the diagnosis and managment in selecting ALS augmentation or reconstruction when performing ACL reconstruction in the patients with high risks of failure and revision surgeries.