| 摘要: |
| 人工韧带作为前交叉韧带（ACL）重建术中移植物的选择，始终是ACL损伤研究领域的热点和焦点问题。军队人员ACL损伤的发病率明显高于普通人群，人工韧带理论上能够弥补生物型移植物来源有限、存在供区并发症等不足，更符合军队伤病员术后快速康复和重返训练的需求，已在军队ACL重建术中得到了广泛应用。但人工韧带的理化特性决定了其手术适应证选择和骨隧道定位等操作具有更高的要求，同时已发表的相关临床研究在其疗效方面也存在分歧和争议，因而经过近20年的发展和推广，至今仍未能完全替代生物型移植物。为了进一步规范和推进人工韧带在军队ACL重建术中的应用，由中国人民解放军医学科学技术委员会骨科专业委员会运动医学关节镜分会牵头，组织相关专家进行临床证据梳理和科学研讨，在手术适应证、操作技术和术后处置等方面达成了本共识（共11个条目），指出人工韧带可单独或联合自体肌腱用于军队人员ACL的初次手术和翻修手术，对超重和需要加速康复的病例具有潜在优势，在手术技术上应注意遵循保留残束、等长定位和皮质骨螺钉固定等要点。 |
| 关键词: 军事人员 前交叉韧带损伤 前交叉韧带重建 人工韧带 韧带先进增强系统 专家共识 |
| DOI：10.16781/j.CN31-2187/R.20240182 |
| 投稿时间：2024-03-22修订日期：2024-10-21 |
| 基金项目: |
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| Consensus on the application of artificial ligaments in military anterior cruciate ligament injury |
| Chinese Specialist Consensus Group of Consensus on the application of artificial ligaments in military anterior cruciate ligament injury |
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| Abstract: |
| Artificial ligament, as a choice of grafts in anterior cruciate ligament (ACL) reconstruction, has always been a focus of ACL injury research. Since the incidence of ACL injury in the military is significantly higher than that in the general population, artificial ligament can theoretically make up for the limited source of biological grafts and donor site complications, more in line with the needs of rapid rehabilitation and retraining of military patients after surgery, and has been widely used in military ACL reconstruction. However, the special physicochemical characteristics of artificial ligament determine higher requirements for surgical indication selection and bone tunnel positioning technique. At the same time, there are differences and controversies in the published clinical studies regarding its efficacy. Therefore, after nearly 2 decades, it has not yet been able to completely replace biological grafts. Aiming to further standardize and promote the application of artificial ligaments in military ACL reconstruction surgery, led by the Sports Medicine Arthroscopy Branch of the Orthopedics Professional Committee of the Chinese People’s Liberation Army Medical Science and Technology Committee, experts were organized to develop 11 consensus items through clinical evidence sorting and scientific discussions from 3 aspects: surgical indications, surgical techniques, and postoperative management. It is pointed out that artificial ligaments can be used alone or in combination with autologous tendons for the primary and revision surgeries of ACL, which has potential advantages for overweight cases and those requiring accelerated recovery. In addition, more attention should be paid to retaining remnants, isometric tunnel positioning, and cortical bone screw fixation. |
| Key words: military personnel anterior cruciate ligament injury anterior cruciate ligament reconstruction artificial ligaments ligament advanced reinforcement system consensus |
