PDF(Pubmed)
Abstract：
Anterior cruciate ligament (ACL) tears are one of the most common sport-related injuries and occur in greater than 3% of athletes in a four-year window of sports participation. Non-contact injuries are the most common mechanism for ACL injury in elite-level athletes, especially with increased valgus and external rotation of the knee when loading eccentrically in flexion. Because of the immense toll these injuries and their recovery take on athletes especially, optimal treatment has been a subject of great interest for some time. Many ACL reconstruction (ACLR) and repair techniques have been implemented and improved in the last two decades, leading to many surgical options for this type of injury. The surgical approach to high-level athletes in particular requires additional attention that may not be necessary in the general population. Important considerations for optimizing ACL treatment in high-level athletes include choosing repair vs. reconstruction, surgical techniques, choice of auto- or allograft, and associated concomitant procedures including other injuries or reinforcing techniques as well as attention to rehabilitation. Here, we discuss a range of surgical techniques from repair to reconstruction, and compare and contrast various reconstructive and reinforcing techniques as well as associated surgical pearls and pitfalls. Good outcomes for athletes suffering from ACL injury are attainable with proper treatment including the principles discussed herein.
摘要：
前交叉韧带（ACL）撕裂是最常见的运动相关损伤之一，在四年的运动参与窗口中，超过3％的运动员发生。非接触损伤是精英级别运动员ACL损伤最常见的机制，特别是在屈曲偏心加载时，膝关节外翻和外旋增加。由于这些伤病及其康复对运动员造成的巨大损失，一段时间以来，最佳治疗一直是人们非常感兴趣的主题。在过去的二十年中，许多ACL重建（ACLR）和修复技术已被实施和改进，导致这种类型的损伤有许多手术选择。特别是对高水平运动员的手术方法需要额外的关注，这在普通人群中可能是不必要的。优化高水平运动员ACL治疗的重要考虑因素包括选择修复与重建,外科技术,选择自体或同种异体移植，以及相关的伴随程序，包括其他伤害或加固技术以及对康复的关注。这里,我们讨论了从修复到重建的一系列手术技术，并比较和对比各种重建和加固技术以及相关的外科珍珠和陷阱。对于患有ACL损伤的运动员,通过包括本文讨论的原理的适当治疗可获得良好的结果。
