Rotatory instability of the knee represents the main reason for failure and poor clinical outcomes regarding anterior cruciate ligament(ACL)reconstruction techniques.It is now clear that the anterolateral complex(ALC)...Rotatory instability of the knee represents the main reason for failure and poor clinical outcomes regarding anterior cruciate ligament(ACL)reconstruction techniques.It is now clear that the anterolateral complex(ALC)of the knee possesses a fundamental role,in association with the ACL,in controlling internal rotation.Over the past decade,ever since the anterolateral ligament has been identified and described as a distinct structure,there has been a renewed interest in the scientific community about the whole ALC:Lateral extra-articular tenodesis have made a comeback in association with ACL reconstructions to improve functional outcomes,reducing the risks of graft failure and associated injuries.Modern ACL reconstruction surgery must therefore investigate residual instability and proceed,when necessary,to extra-articular techniques,whether functional tenodesis or anatomical reconstruction.This review aims to investigate the latest anatomical and histological descriptions,and the role in rotational control and knee biomechanics of the ALC and its components.The diagnostic tools for its identification,different reconstruction techniques,and possible surgical indications are described..In addition,clinical and functional results available in the literature are reported.展开更多
Objective: To analyze the traumatic pathological characteristics of posterolateral dislocation of knee joints and its treatment.Methods: Nine cases of posterolateral dislocation of knee joint ,5 cases of fresh injurie...Objective: To analyze the traumatic pathological characteristics of posterolateral dislocation of knee joints and its treatment.Methods: Nine cases of posterolateral dislocation of knee joint ,5 cases of fresh injuries (the fresh injury group) and 4 cases of old injuries ( the old injury group) were reviewed and analyzed. In the fresh injury group 4 cases failed in close reduction due to "buttonholing" through the medial jo int,among them 3 cases underwent repair of the damaged ligaments. In the old in jury group 2 cases underwent ACL and MCL repair only in acute stage,but re-dis located. Of the rest 2 cases 1 was associated with peroneal nerve injury and the other was not treated in acute stage. One case was associated with comminuted f racture of the tibial condyle and popliteal artery injury. Open reduction was pe rformed in 3 cases. One case was fixed with 2-crossed pin and another was fixe d with one pin through the tibial and femoral condyle and second pin with olecra nization fixation. Plaster immobilization for 6-8 weeks respectively was requir ed. In the old injury group in 1 case ACL and PCL repair (Augustine method) and posterolateral structure were performed and olecranization fixation and plaster immobilization for 6 weeks was needed. Arthrodesis of the knee was done for the patient with comminuted fracture of the tibial condyle and popliteal artery inj ury. Results: All the cases were followed up for 1-23 years (averag e 6 years). Knee stability in 4 cases with repair of the ligaments was improved,although PDT showed (+) with different degrees. The results of the patients tre ated with ligamentous reconstruction were much better than those of the patients without any repair. Conclusions: Well understanding of the traumatic pathological c haracteristics,repair of the damaged ligaments,augmentation of olecranization fixation and postoperative immobilization for 6 weeks are the key points of succ essful treatment.展开更多
文摘Rotatory instability of the knee represents the main reason for failure and poor clinical outcomes regarding anterior cruciate ligament(ACL)reconstruction techniques.It is now clear that the anterolateral complex(ALC)of the knee possesses a fundamental role,in association with the ACL,in controlling internal rotation.Over the past decade,ever since the anterolateral ligament has been identified and described as a distinct structure,there has been a renewed interest in the scientific community about the whole ALC:Lateral extra-articular tenodesis have made a comeback in association with ACL reconstructions to improve functional outcomes,reducing the risks of graft failure and associated injuries.Modern ACL reconstruction surgery must therefore investigate residual instability and proceed,when necessary,to extra-articular techniques,whether functional tenodesis or anatomical reconstruction.This review aims to investigate the latest anatomical and histological descriptions,and the role in rotational control and knee biomechanics of the ALC and its components.The diagnostic tools for its identification,different reconstruction techniques,and possible surgical indications are described..In addition,clinical and functional results available in the literature are reported.
文摘Objective: To analyze the traumatic pathological characteristics of posterolateral dislocation of knee joints and its treatment.Methods: Nine cases of posterolateral dislocation of knee joint ,5 cases of fresh injuries (the fresh injury group) and 4 cases of old injuries ( the old injury group) were reviewed and analyzed. In the fresh injury group 4 cases failed in close reduction due to "buttonholing" through the medial jo int,among them 3 cases underwent repair of the damaged ligaments. In the old in jury group 2 cases underwent ACL and MCL repair only in acute stage,but re-dis located. Of the rest 2 cases 1 was associated with peroneal nerve injury and the other was not treated in acute stage. One case was associated with comminuted f racture of the tibial condyle and popliteal artery injury. Open reduction was pe rformed in 3 cases. One case was fixed with 2-crossed pin and another was fixe d with one pin through the tibial and femoral condyle and second pin with olecra nization fixation. Plaster immobilization for 6-8 weeks respectively was requir ed. In the old injury group in 1 case ACL and PCL repair (Augustine method) and posterolateral structure were performed and olecranization fixation and plaster immobilization for 6 weeks was needed. Arthrodesis of the knee was done for the patient with comminuted fracture of the tibial condyle and popliteal artery inj ury. Results: All the cases were followed up for 1-23 years (averag e 6 years). Knee stability in 4 cases with repair of the ligaments was improved,although PDT showed (+) with different degrees. The results of the patients tre ated with ligamentous reconstruction were much better than those of the patients without any repair. Conclusions: Well understanding of the traumatic pathological c haracteristics,repair of the damaged ligaments,augmentation of olecranization fixation and postoperative immobilization for 6 weeks are the key points of succ essful treatment.
