Journal of the Korean Orthopaedic Association (대한정형외과학회지)

Korean Orthopaedic Association (대한정형외과학회)
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What Has Been Learned in Anterior Cruciate Ligament Reconstruction during the Past 20 Years?

전방십자인대 재건수술은 지난 20년간 어떻게 발전하였나?

  • Ro, Du Hyun (Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Han, Hyuk-Soo (Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Lee, Myung Chul (Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine)
  • 노두현 (서울대학교 의과대학 서울대학교병원 정형외과학교실) ;
  • 한혁수 (서울대학교 의과대학 서울대학교병원 정형외과학교실) ;
  • 이명철 (서울대학교 의과대학 서울대학교병원 정형외과학교실)
  • Received : 2020.09.01
  • Accepted : 2020.10.12
  • Published : 2021.02.28
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Abstract

Considerable progress on anterior cruciate ligament reconstruction surgery has been made over the past 20 years, and the results have improved significantly. An anatomical understanding of the anterior cruciate ligament has also changed, and the surgical technique has also changed accordingly. The double-bundle concept is still valid, but the ribbon-shaped anterior cruciate ligament concept, including direct fiber and indirect fiber, is gradually replacing it. The isometry point theory no longer exists, and various surgical methods, such as single-bundle anatomical reconstruction, double-bundle reconstruction, remnant preservation, and rectangular tunnel technique, are being performed. Regarding the graft, interest in the bone-patellar tendon-bone, patellar tendon, quadriceps tendon, and allogeneic tendon change over time, and this change is ongoing.

전방십자인대 재건수술 술기는 최근 20년간 많은 발전을 이뤘으며 결과가 과거에 비해 크게 향상되었다. 전방십자인대의 해부학적 이해 또한 20년 전과 현재가 다르며 이에 맞추어 수술 방법 또한 변화하고 있다. 이중다발 개념은 여전히 유효하나 리본 형태의 전방십자인대 모양, 직접 섬유, 간접 섬유가 그 개념을 서서히 대체하고 있다. 등장점 개념은 더 이상 존재하지 않으며 단일다발 해부학적 재건, 이중다발 해부학적 재건, 잔류조직 보존술식, 직각터널 술식 등 다양한 수술 방법들이 행해지고 있으며 논문을 통해 검증되고 있다. 이식건의 종류에 있어서도 자가건인 골-슬개건-골, 슬건, 대퇴사두근건, 동종건에 대한 관심이 시간에 따라 변화하고 있으며 이런 변화는 현재 진행형이다.

Keywords

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