tailieunhanh - Phương pháp phẫu thuật đầu gối

Phương pháp tiếp cận phẫu thuật đến các khía cạnh sau của đầu gối thường không cần thiết, và sử dụng của họ ĐÃ Trở thành Thậm chí hiếm hơn với sự tinh vi ngày càng tăng của công nghệ arthroscopic. Kết quả là, các bác sĩ phẫu thuật chỉnh hình đào tạo không thường xúc để sử dụng thực tế của phẫu thuật bóc tách xung quanh | Surgical Approaches to the Posteromedial and Posterolateral Aspects of the Knee Michael J. Medvecky MD and Frank R. Noyes MD Abstract Surgical approaches to the posterior aspect of the knee are not commonly needed and their use has become even rarer with the increasing sophistication of arthroscopic technology. As a result physicians in orthopaedic surgical training are not often exposed to the practical use of surgical dissection around the posterior corners of the knee. For certain procedures however greater clinical utility and decreased surgical morbidity render focused posterior exposure the preferred alternative to the classic popliteal dissection with its wide exposure of the popliteal anatomy. Surgical indications include ligament repair or reconstruction around the posteromedial or posterolateral aspect of the knee inside-out meniscal repair posterior cruciate ligament tibial inlay reconstruction and Baker s cyst excision. To minimize complications these focused approaches require adeptness with the complex anatomy of the posterior posteromedial and posterolateral aspects. J Am Acad Orthop Surg 2005 13 121-128 With continuing advances in arthroscopic surgical techniques open incisions around the knee have become less common and thus are less frequently experienced by physicians in orthopaedic surgery training. In addition the infrequent use of popliteal fossa surgical dissection and its potential for neurovascular complications lend an undesirable challenge to surgical approaches to the posterior aspect of the knee. Recently however posterior cruciate ligament PCL tibial inlay reconstruction which requires a posterior approach has received increased attention and more frequent 2 Additional indications for a posterior surgical approach to the knee are inside-out meniscal repair repair with or without augmentation of acute traumatic medial or lateral ligamentous injuries reconstruction of chronic medial or lateral ligamentous injuries open reduction .