tailieunhanh - Suy dây chằng cruciate trước: Nguyên tắc điều trị

Chấn thương dây chằng cruciate trước (ACL) thường dẫn đến khuyết tật chức năng, đặc biệt là nhảy, cắt, và các hoạt động giảm tốc độ. Một số bệnh nhân có thể phục vụ này mất chức năng, trong khi những người khác đòi hỏi phải phẫu thuật tái tạo dây chằng để cung cấp ổn định và bảo vệ các khum chấn thương thêm. | Anterior Cruciate Ligament Insufficiency Principles of Treatment Robert L. Larson MD and Mario Taillon MD FRCS C Abstract Anterior cruciate ligament ACL injuries often result in functional disability particularly in jumping cutting and deceleration activities. Some patients can accommodate to this functional loss while others require surgical reconstruction of the ligament to provide stability and to protect the meniscus from further injury. Nonoperative management involves an intensive rehabilitation program patient counseling about high-risk activities and measures to prevent recurrent injuries. Surgical reconstruction of the ACL involves the technical factors of graft selection positioning fixation and tensioning and the avoidance of stress risers. A supervised and intensive rehabilitation program is necessary to achieve optimal results. J Am Acad Orthop Surg 1994 2 26-35 The anterior cruciate ligament ACL has been one of the most extensively studied ligaments in the body. Its importance in knee function has been emphasized particularly for athletes who require knee stability in activities such as running cutting and kicking. Although an improvement in function can be achieved by present surgical techniques the biologic and physiologic characteristics of the normal ACL are not fully restored. The normal ACL has proprioceptive senses that help protect the knee joint during use it has a degree of viscoelasticity that allows it to stretch and return to its resting length without structural damage it has a physical configuration with multiple bands and a mul-tiaxial function that guides the knee through its complex helicoid motion including both rotational and translational forces and it has broad insertion sites which allow the normal kinematics of knee motion to occur with stability in activities such as walking running jumping and kicking. Anatomy The ACL is intracapsular but extrasynovial. Its predominant source of blood supply is the middle genicular artery .