解剖单束双束重建比较研究作者ahmed gad运动医学.pptx

ComparativestudybetweenanatomicsinglebundleanatomicdoublebundleACLreconstructionBy

AhmedGad

LecturerofOrthopedicSurgery

CairoUniversityorthopaedics.kasralainy.edu.eg

ACLReconstructionReconstructionoftheACLisoneofthemostfrequentlyperformedoperationsinorthopedicsportsmedicine.

GOALS:1#Returntoactivitiesrestorekneebiomechanics2#Changethenatural

historyofDJD

MoststandardsinglebundleACLreconstructiontechniquesprovidesatisfactorysubjectiveresultsandrestoresAPstabilityinthevastmajorityofpatientsintheshortterm.

BUT......Longtermresults????

esofSBACLreconstruction27-79%ofACLRptswilldevelopDJDby10-15yrs#HartAJ,JBJS2005#SeonJK,IntOrtho2006#SalmonLJ,Arthros2007#CohenM,Arthros2007#FithianD,Knee2006

So,it’sevidentthatmanysinglebundleACLreconstructiontechniquesdoesnotperfectlyrestorenormalkneekinematics.Agliettip.,Surgeryoftheknee,2006Moreover,manyauthorshaveclinicallydetectedresidualminimalrotatoryinstabilityinalmostafifthofcasesindependentofthegraft,surgicaltechniqueandchoiceoffixationdevice.

TheadvancingknowledgeofACLanatomyhasleadtodevelopmentofnewACLreconstructiontechniquesthatreproducenearnativeACLanatomy.

DoubleBundleReconstructionWaslaterdevelopedtobetterreproducenativeanatomyandwassoonfollowedbytheuseoftheterm(Anatomic)whendescribinganACLreconstructiontechnique.

Doublebundlereconstructiondoesnotnecessarymeanitisanatomicreconstruction.DefinitionofanatomicACLreconstruction

IsfunctionalrestorationofACLtoitsnativedimensions,orientationinsertionsites.

RomanowskiJ.,FuF.,OperTechsportsMed,2009ThismeansthatthetunnelsareplacedinthenativeACLinsertionsites,regardlessofhowmanybundlesareused.

AnatomicH