tailieunhanh - Phẫu thuật dây chằng

Sửa đổi trước cruciate dây chằng (ACL) tái thiết được chỉ định cho bệnh nhân lựa chọn với sự bất ổn tái phát sau khi một thủ tục chính thất bại. Nguyên nhân của sự thất bại Phải Hãy cẩn thận để tránh cạm bẫy mà có thể Xác định Nguyên nhân sửa đổi để thất bại là tốt. Mô hình bất ổn liên quan phải công nhận và sửa chữa | Revision Anterior Cruciate Ligament Reconstruction Surgery Mark H. Getelman MD and Marc J. Friedman MD Abstract Revision anterior cruciate ligament ACL reconstruction is indicated for selected patients with recurrent instability after a failed primary procedure. The cause of the failure must be carefully identified to avoid pitfalls that may cause the revision to fail as well. Associated instability patterns must be recognized and corrected to achieve a successful result. The choice of graft the problem of retained hardware and tunnel placement are the major challenges of revision ACL reconstruction. The patient must have reasonable expectations and understand that the primary goal of surgery is restoration of the ability to perform activities of daily living rather than a return to competitive athletics. The results of revision ACL reconstructions are not as good as those after primary reconstructions however the procedure appears to be beneficial for most patients. J Am Acad Orthop Surg 1999 7 189-198 Anterior cruciate ligament ACL reconstruction was first described by Hey-Groves in 1917. Since then significant improvements have been made in performing intra-articular reconstructions. With current techniques and accelerated rehabilitation protocols the morbidity has been greatly decreased. Reconstruction is now widely accepted as the treatment of choice for individuals with functional instability due to an ACL-deficient knee. It has been estimated that between 60 000 and 75 000 ACL reconstructions are performed annually in the United Restoration of stability and return to activity can generally be expected after ACL reconstruction with reported long-term success rates of between 75 and 95 .2 However these results indicate that a subset of patients will have ACL grafts that do not adequately stabilize the knee. It has been reported that recurrent instability and graft failure will develop in as many as 8 of patients who undergo primary ACL .