Reconstruction of the ligamentous-tendinous complex of the knee joint, ensuring its varus stability
- 作者: Khominets V.V.1, Kudyashev A.L.1, Gaivoronskiy I.V.1, Bazarov I.S.1, Grankin A.S.1, Semenov A.A.1, Konokotin D.A.1
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隶属关系:
- Military medical academy of S.M. Kirov
- 期: 卷 24, 编号 1 (2022)
- 页面: 61-68
- 栏目: Original Study Article
- URL: https://journals.rcsi.science/1682-7392/article/view/87931
- DOI: https://doi.org/10.17816/brmma87931
- ID: 87931
如何引用文章
详细
А new technique for anatomical reconstruction of the ligament–tendon complex of the knee joint, which restores its varus stability, in patients with multiligament injury is substantiated. The technical feasibility, safety, and effectiveness of the proposed technique were evaluated in an anatomical experiment. The study was performed on eight lower extremities of four unfixed corpses. After simulating the varus instability of the knee joint, the plasty of the ligament–tendon complex providing the varus stability of the knee joint was performed according to the proposed technique. The essence of the proposed technique is the simultaneous restoration of the peroneal collateral ligament, popliteal tendon, and popliteal–peroneal ligament using a single autograft of a semitendinosus muscle. After simulating the surgical procedure on anatomical specimens, the varus stability of the knee joint was evaluated based on the results of functional radiography. The safety of the experimental procedure was evaluated based on the results of the applied morphometric study of the distance from the reconstructed elements of the posterolateral corner of the knee joint to the popliteal artery and the common peroneal nerve in the 90-degree flexion position in the knee joint. Accordingly, the formed bone tunnels for a single autograft were located at a safe distance from the elements of the neurovascular bundle of the popliteal fossa. The technical possibility of reconstruction of the collateral peroneal ligament, popliteal tendon, and popliteal–peroneal ligament according to the proposed technique. After simulating the reconstruction of elements of the posterolateral corner of the knee joint, varus stability was objectified by a series of functional X-ray studies of the anatomical specimens. The results indicate the technical feasibility, effectiveness, and relative safety of the proposed method of reconstruction of the ligament–tendon complex of the posterolateral corner of the knee joint providing the varus stability of the knee joint in patients with multiligament injury.
作者简介
Vladimir Khominets
Military medical academy of S.M. Kirov
Email: khominets_62@mail.ru
ORCID iD: 0000-0001-9391-3316
SPIN 代码: 5174-4433
Scopus 作者 ID: 6504618617
doctor of medical sciences, professor
俄罗斯联邦, Saint PeterburgAleksey Kudyashev
Military medical academy of S.M. Kirov
Email: a.kudyashev@gmail.com
ORCID iD: 0000-0002-8561-2289
SPIN 代码: 6138-0950
doctor of medical sciences, associate professor
俄罗斯联邦, Saint PeterburgIvan Gaivoronskiy
Military medical academy of S.M. Kirov
Email: i.v.gaivoronsky@mail.ru
ORCID iD: 0000-0002-6836-5650
SPIN 代码: 1898-3355
doctor of medical sciences, professor
俄罗斯联邦, Saint PeterburgIvan Bazarov
Military medical academy of S.M. Kirov
Email: dok055@yandex.ru
ORCID iD: 0000-0002-4708-493X
SPIN 代码: 4745-2901
head of department
俄罗斯联邦, Saint PeterburgAleksey Grankin
Military medical academy of S.M. Kirov
Email: aleksey-grankin@yandex.ru
ORCID iD: 0000-0002-4565-9066
SPIN 代码: 1122-8388
candidate of medical sciences
俄罗斯联邦, Saint PeterburgAleksey Semenov
Military medical academy of S.M. Kirov
编辑信件的主要联系方式.
Email: semfeodosia82@mail.ru
SPIN 代码: 1147-3072
candidate of medical sciences
俄罗斯联邦, Saint PeterburgDmitri Konokotin
Military medical academy of S.M. Kirov
Email: konokotin.dmirty@yandex.ru
ORCID iD: 0000-0003-3100-0321
SPIN 代码: 1625-0543
Adjunct
俄罗斯联邦, Saint Peterburg参考
- Khominets VV, Shapovalov VM, Kapilevich BYa, et al. Objective roentgenologic diagnostics of anterior cruciform ligamentous disruption in servicemen. Military Medical Journal. 2016;337(2):28–30. (In Russ.). doi: 10.17816/RMMJ73555
- Brizhan LK, Davidov DV, Buryachenko BP, et al. Modern technologies in rehabilitation of patient after total knee replacement. Bulletin of Pirogov National Medical and Surgical Center. 2018;13(2):74–77. (In Russ.).
- Lychagin AV, Gritsyuk AA, Gasymov ASh, et al. Features of preoperative planning of patients with degenerative-dystrophic diseases of the hip and knee joints. Military Medical Journal. 2019;340(2):36–45. (In Russ.). doi: 10.17816/RMMJ72832
- Semenov AA, Gaivoronsky IV, Khominets VV, et al. The anatomy of structures of the knee joint at deforming arthrosis according to the data of vital and post-vital studies. Morphological Newsletter. 2019;27(3):32–38. (In Russ.). doi: 10.20340/mv-mn.2019(27).3.32-38
- Abulhasan JF, Grey MJ. Anatomy and physiology of knee stability. J Funct Morphol Kinesiol. 2017;2(4):34. doi: 10.3390/jfmk2040034
- Takeda S, Tajima G, Fujino K, et al. Morphology of the femoral insertion of the lateral collateral ligament and popliteus tendon. Knee Surg Sports Traumatol Arthrosc. 2014;23(10):3049–3054. doi: 10.1007/s00167-014-3059-5
- Nannaparaju M, Mortada S, Wiik A, et al. Posterolateral corner injuries: Epidemiology, anatomy, biomechanics and diagnosis. Injury. 2018;49(6):1024–1031. doi: 10.1016/j.injury.2017.10.008
- Weiss S, Krause M, Frosch K-H. Posterolateral corner of the knee: a systematic literature review of current concepts of arthroscopic reconstruction. Arch Orthop Trauma Surg. 2020;140(12):2003–2012. doi: 10.1007/s00402-020-03607-z
- Stannard JP, Stannard JT, Cook JL. Surgical Treatment of Combined ACL, PCL, and Lateral Side Injuries. Sports Med Arthrosc Rev. 2020;28(3):94–99. doi: 10.1097/JSA.0000000000000275
- Khominets VV, Rikun OV, Shapovalov VM, et al. Revision anterior cruciate ligament of knee reconstruction in case of anterolateral rotation knee instability in servicemen. Military Medical Journal. 2016;337(6):24–29. (In Russ.). doi: 10.17816/RMMJ73635
- Goncharov EN, Koval OA, Dubrov VE, et al. Mid-Term Results of Simultaneous Reconstruction of Anterior Cruciate and Anterolateral Ligaments in Athletes. Traumatology and Orthopedics of Russia. 2020;26(1):62–71. (In Russ.). doi: 10.21823/2311-2905-2020-26-1-62-71
- Shulepov DA, Salihov MR, Zlobin OV. Mid-term results of multi-ligament posterior and anterior cruciate ligament reconstruction using a modified method of bone tunnels drilling. N.N. Priorov Journal of Traumatology and Orthopedics. 2019;26(4):12–21. (In Russ.). doi: 10.17116/vto201904112
- Grawe B, Schroeder AJ, Kakazu R, et al. Lateral collateral ligament injury about the knee: anatomy, evaluation, and management. J Am Acad Orthop Surg. 2018;26(6):e120–e127. doi: 10.5435/JAAOS-D-16-00028
- Patent RUS № 2735997 C1, MPK A61B 17/56. Zayavl. № 2020112600/25.03.2020. Khominets VV, Grankin AS, Bazarov IS, et al. Sposob odnomomentnogo vosstanovleniya malobertsovoi kollateral’noi svyazki i sukhozhiliya podkolennoi myshtsy kolennogo sustava. (In Russ.).
- Patent RUS for useful model № 197909 U1, MPK A61B 5/103. Zayavl. № 2020101175/10.01.2020. Bazarov IS, Khominets VV, Zorin VN, et al. Ustroistvo dlya provedeniya nagruzki na svyazochnyi apparat pri rentgenologicheskoi otsenke stepeni nestabil’nosti kolennogo sustava. (In Russ.).
- McKean D, Yoong P, Yanny S, et al. The popliteal fibular ligament in acute knee trauma: patterns of injury on MR imaging. Skeletal Radiology. 2015;44(10):1413–1419. doi: 10.1007/s00256-015-2176-7
- Teo HLT, Ang KXM, Sir Loh YJ. A reproducible reference point for the common peroneal nerve during surgery at the posterolateral corner of the knee: a cadaveric study. Knee Surg Relat Res. 2020;32:23. doi: 10.1186/s43019-020-00039-2
- Shulepov DA, Salikhov MR, Zlobin OV, et al. Arthroscopic surgical treatment of patients with posterolateral knee instability. Modern Problems of Science and Education Surgery. 2020;(5):130–130. (In Russ.). doi: 10.17513/spno.30220
- Naylor WM, Johnson DJ, Welter JM, Dunn ASM. Injury to the Popliteal Artery and Vein During Open Fibular Collateral Ligament Reconstruction: A Case Report. JBJS Case Connector. 2020;10(3):e19. 00666. doi: 10.2106/JBJS.CC.19.00666
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