{"id":575,"date":"2026-10-13T06:21:29","date_gmt":"2026-10-12T23:21:29","guid":{"rendered":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/13\/noi-soi-tai-tao-day-chang-cheo-sau-bang-ky-thuat-all-inside-nguyen-ly-va-thuc-hanh\/"},"modified":"2026-10-13T06:21:29","modified_gmt":"2026-10-12T23:21:29","slug":"noi-soi-tai-tao-day-chang-cheo-sau-bang-ky-thuat-all-inside-nguyen-ly-va-thuc-hanh","status":"publish","type":"post","link":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/13\/noi-soi-tai-tao-day-chang-cheo-sau-bang-ky-thuat-all-inside-nguyen-ly-va-thuc-hanh\/","title":{"rendered":"N\u1ed9i soi t\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng ch\u00e9o sau b\u1eb1ng k\u1ef9 thu\u1eadt All-inside: Nguy\u00ean l\u00fd v\u00e0 Th\u1ef1c h\u00e0nh"},"content":{"rendered":"

K\u1ef9 thu\u1eadt All-inside trong ph\u1eabu thu\u1eadt d\u00e2y ch\u1eb1ng ch\u00e9o sau<\/h2>\n

M\u1eb7c d\u00f9 t\u00e0i li\u1ec7u tham kh\u1ea3o ch\u00ednh ch\u1ee7 y\u1ebfu t\u1eadp trung v\u00e0o c\u00e1c k\u1ef9 thu\u1eadt m\u1edf truy\u1ec1n th\u1ed1ng cho PCL, xu h\u01b0\u1edbng chuy\u1ec3n sang n\u1ed9i soi \u0111ang gia t\u0103ng nh\u1edd l\u1ee3i \u00edch v\u1ec1 x\u00e2m l\u1ea5n t\u1ed1i thi\u1ec3u v\u00e0 ph\u1ee5c h\u1ed3i nhanh h\u01a1n [3]. K\u1ef9 thu\u1eadt all-inside<\/strong> (t\u1ea5t c\u1ea3 b\u00ean trong) \u0111\u1eb7c bi\u1ec7t ph\u00f9 h\u1ee3p v\u1edbi gh\u00e9p d\u00e2y ch\u1eb1ng hamstring, n\u01a1i c\u00e1c \u0111\u1ea7u gh\u00e9p \u0111\u01b0\u1ee3c c\u1ed1 \u0111\u1ecbnh ho\u00e0n to\u00e0n b\u00ean trong kh\u1edbp m\u00e0 kh\u00f4ng c\u1ea7n \u0111\u1eb7t ch\u1ed1t tr\u00ean da. \u0110\u1ed1i v\u1edbi PCL, k\u1ef9 thu\u1eadt n\u00e0y \u0111\u00f2i h\u1ecfi s\u1ef1 k\u1ebft h\u1ee3p gi\u1eefa vi\u1ec7c khoan \u1ed1ng qua \u0111\u1ed1t x\u01b0\u01a1ng v\u00e0 s\u1eed d\u1ee5ng thi\u1ebft b\u1ecb c\u1ed1 \u0111\u1ecbnh n\u1ed9i t\u1ea1i \u0111\u1ec3 tr\u00e1nh l\u00e0m t\u1ed5n th\u01b0\u01a1ng m\u00f4 m\u1ec1m nh\u01b0 d\u00e2y th\u1ea7n kinh ch\u1ed3i sau [4].<\/p>\n

So s\u00e1nh hi\u1ec7u qu\u1ea3: M\u1ed9t b\u00f3 hay Hai b\u00f3?<\/h2>\n

V\u1ea5n \u0111\u1ec1 l\u1ef1a ch\u1ecdn gi\u1eefa k\u1ef9 thu\u1eadt m\u1ed9t b\u00f3 (single-bundle) v\u00e0 hai b\u00f3 (double-bundle) v\u1eabn \u0111ang g\u00e2y tranh c\u00e3i, nh\u01b0ng b\u1eb1ng ch\u1ee9ng hi\u1ec7n t\u1ea1i nghi\u00eang v\u1ec1 \u01b0u th\u1ebf c\u1ee7a k\u1ef9 thu\u1eadt hai b\u00f3<\/strong> trong vi\u1ec7c kh\u00f4i ph\u1ee5c \u1ed5n \u0111\u1ecbnh d\u1ecbch chuy\u1ec3n sau [1]. C\u00e1c nghi\u00ean c\u1ee9u sinh h\u1ecdc c\u01a1 h\u1ecdc v\u00e0 l\u00e2m s\u00e0ng cho th\u1ea5y k\u1ef9 thu\u1eadt hai b\u00f3 t\u00e1i t\u1ea1o \u0111\u01b0\u1ee3c \u0111\u1ed9ng l\u1ef1c h\u1ecdc kh\u1edbp g\u1ea7n nh\u01b0 b\u00ecnh th\u01b0\u1eddng h\u01a1n so v\u1edbi m\u1ed9t b\u00f3, \u0111\u1eb7c bi\u1ec7t l\u00e0 trong vi\u1ec7c ki\u1ec3m so\u00e1t d\u1ecbch chuy\u1ec3n sau c\u1ee7a x\u01b0\u01a1ng b\u00e1nh ch\u00e8 [4].<\/p>\n

B\u1ed9 ph\u1eadn d\u01b0\u1edbi li\u00ean k\u1ebft tr\u01b0\u1edbc (ALB) v\u00e0 b\u1ed9 ph\u1eadn gi\u1eefa li\u00ean k\u1ebft sau (MGB) c\u00f3 \u0111i\u1ec3m b\u00e1m r\u1ed9ng h\u01a1n \u1edf ph\u00eda femur, cho ph\u00e9p khoan hai \u1ed1ng ri\u00eang bi\u1ec7t. Tuy nhi\u00ean, \u1ed1ng \u0111\u1ed1t x\u01b0\u01a1ng tibia th\u01b0\u1eddng c\u1ed3ng k\u1ec1nh h\u01a1n v\u00e0 th\u01b0\u1eddng ch\u1ec9 khoan \u0111\u01b0\u1ee3c m\u1ed9t \u1ed1ng duy nh\u1ea5t [1]. M\u1eb7c d\u00f9 vi\u1ec7c khoan hai \u1ed1ng c\u00f3 th\u1ec3 l\u00e0m m\u1ea5t th\u00eam x\u01b0\u01a1ng \u1edf v\u00f9ng ch\u00e0y trong femur, d\u1eef li\u1ec7u l\u00e2m s\u00e0ng ch\u01b0a ghi nh\u1eadn g\u00e3y ch\u00e0y trong femur \u0111\u00e1ng k\u1ec3 [4].<\/p>\n

\u01afu \u0111i\u1ec3m c\u1ee7a k\u1ef9 thu\u1eadt Double-Bundle<\/h3>\n
    \n
  • T\u00e1i t\u1ea1o \u0111\u1ed9ng l\u1ef1c h\u1ecdc kh\u1edbp kh\u1edbp g\u1ea7n nh\u01b0 b\u00ecnh th\u01b0\u1eddng h\u01a1n.<\/li>\n
  • C\u1ea3i thi\u1ec7n d\u1ecbch chuy\u1ec3n sau tr\u00ean X-quang c\u0103ng th\u1eb3ng v\u00e0 \u0111i\u1ec3m s\u1ed1 IKDC b\u00ecnh th\u01b0\u1eddng\/g\u1ea7n b\u00ecnh th\u01b0\u1eddng [4].<\/li>\n
  • Kh\u1eafc ph\u1ee5c h\u1ea1n ch\u1ebf v\u1ec1 g\u00f3c xoay c\u1ee7a m\u1ed9t b\u00f3 \u0111\u01a1n.<\/li>\n<\/ul>\n

    K\u1ef9 thu\u1eadt khoan \u1ed1ng v\u00e0 Tensioning Gh\u00e9p<\/h2>\n

    B\u00ean c\u1ea1nh v\u1ea5n \u0111\u1ec1 m\u1ed9t hay hai b\u00f3, k\u1ef9 thu\u1eadt khoan \u1ed1ng c\u0169ng l\u00e0 \u0111i\u1ec3m ngh\u1ebdn quan tr\u1ecdng. M\u1ed9t m\u1ed1i lo ng\u1ea1i l\u1edbn l\u00e0 g\u00f3c “gi\u1ebft ng\u01b0\u1eddi” (killer turn)<\/strong>, g\u00f3c nh\u1ecdn khi gh\u00e9p chui qua \u1ed1ng tibia v\u00e0 ti\u1ebfn ra ph\u00eda tr\u01b0\u1edbc \u0111\u1ec3 \u0111\u1ea1t \u0111i\u1ec3m b\u00e1m femur. G\u00f3c n\u00e0y c\u00f3 th\u1ec3 g\u00e2y m\u00e0i m\u00f2n, m\u1ecfng \u0111i v\u00e0 r\u00e3 s\u1ee3i c\u1ee7a gh\u00e9p [5].<\/p>\n

    T\u00ednh c\u0103ng (tensioning) c\u1ee7a gh\u00e9p c\u0169ng \u0111\u00f3ng vai tr\u00f2 then ch\u1ed1t. C\u00e1c h\u1ec7 th\u1ed1ng th\u1eed nghi\u1ec7m robot \u0111\u00e3 l\u00e0m r\u00f5 r\u1eb1ng vi\u1ec7c c\u1ed1 \u0111\u1ecbnh gh\u00e9p \u1edf t\u01b0 th\u1ebf du\u1ed7i ho\u00e0n to\u00e0n m\u00e0 kh\u00f4ng ch\u1ecbu t\u1ea3i s\u1ebd t\u1ea1o ra kh\u1edbp qu\u00e1 h\u1ea1n ch\u1ebf v\u1edbi d\u1ecbch chuy\u1ec3n tr\u01b0\u1edbc-sau gi\u1ea3m \u0111\u00e1ng k\u1ec3 [4]. Ng\u01b0\u1ee3c l\u1ea1i, c\u1ed1 \u0111\u1ecbnh \u1edf 90 \u0111\u1ed9 g\u1eadp \u0111\u1ea7u g\u1ed1i cho \u0111\u1ed9ng l\u1ef1c h\u1ecdc kh\u1edbp gi\u1ed1ng v\u1edbi kh\u1edbp nguy\u00ean v\u1eb9n. C\u1ed1 \u0111\u1ecbnh \u1edf t\u01b0 th\u1ebf du\u1ed7i c\u00f3 th\u1ec3 l\u00e0m t\u0103ng l\u1ef1c c\u0103ng t\u1ea1i ch\u1ed7 c\u1ee7a gh\u00e9p [4].<\/p>\n

    Th\u1ef1c h\u00e0nh ph\u1eabu thu\u1eadt v\u00e0 Ti\u1ebfp c\u1eadn<\/h2>\n

    D\u00f9 n\u1ed9i soi l\u00e0 xu h\u01b0\u1edbng, nhi\u1ec1u k\u1ef9 thu\u1eadt PCL v\u1eabn \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 d\u01b0\u1edbi d\u1ea1ng ph\u1eabu thu\u1eadt m\u1edf \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o \u0111\u1ed9 ch\u00ednh x\u00e1c v\u1ec1 v\u1ecb tr\u00ed \u1ed1ng. Khi th\u1ef1c hi\u1ec7n qua ti\u1ebfp c\u1eadn b\u00ean trong (v\u00ed d\u1ee5: t\u1ed5n th\u01b0\u01a1ng t\u00e1ch r\u1eddi tibia), vi\u1ec7c gi\u1ea3i ph\u1eabu da v\u00e0 m\u00f4 d\u01b0\u1edbi da c\u1ea7n di\u1ec5n ra t\u1eeb g\u00f3c tr\u01b0\u1edbc c\u1ee7a x\u01b0\u01a1ng b\u00e1nh ch\u00e8 \u0111\u1ebfn g\u00f3c posteromedial [2].<\/p>\n

    \u0110\u1ed1i v\u1edbi c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3 nh\u01b0 PCL t\u00e1ch r\u1eddi b\u1eb1ng x\u01b0\u01a1ng, thu\u1eadt to\u00e1n \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 bao g\u1ed3m s\u1eeda ch\u1eefa tr\u1ef1c ti\u1ebfp ho\u1eb7c t\u00e1i t\u1ea1o t\u00f9y thu\u1ed9c v\u00e0o k\u00edch th\u01b0\u1edbc m\u1ea3nh v\u1ee1 v\u00e0 th\u1eddi gian t\u1ed5n th\u01b0\u01a1ng [2]. Trong khi \u0111\u00f3, c\u00e1c k\u1ef9 thu\u1eadt n\u1ed9i soi h\u1ed7 tr\u1ee3 (arthroscopically aided) ng\u00e0y c\u00e0ng ph\u1ed5 bi\u1ebfn \u0111\u1ec3 \u0111\u1ecbnh v\u1ecb \u1ed1ng ch\u00ednh x\u00e1c h\u01a1n tr\u01b0\u1edbc khi th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt m\u1edf n\u1ebfu c\u1ea7n thi\u1ebft [6].<\/p>\n

    \u0110i\u1ec1u ki\u1ec7n th\u00e0nh c\u00f4ng c\u1ee7a k\u1ef9 thu\u1eadt All-inside<\/h3>\n

    K\u1ef9 thu\u1eadt all-inside cho PCL \u0111\u00f2i h\u1ecfi s\u1ef1 k\u1ebft h\u1ee3p gi\u1eefa:<\/p>\n

      \n
    1. V\u1ecb tr\u00ed \u1ed1ng ch\u00ednh x\u00e1c:<\/strong> Hai \u1ed1ng femur v\u00e0 m\u1ed9t \u1ed1ng tibia (cho double-bundle).<\/li>\n
    2. Thi\u1ebft b\u1ecb c\u1ed1 \u0111\u1ecbnh ph\u00f9 h\u1ee3p:<\/strong> S\u1eed d\u1ee5ng c\u00e1c thi\u1ebft b\u1ecb n\u1ed9i t\u1ea1i \u0111\u1ec3 tr\u00e1nh t\u1ed5n th\u01b0\u01a1ng d\u00e2y th\u1ea7n kinh ch\u1ed3i sau.<\/li>\n
    3. T\u01b0 th\u1ebf kh\u1edbp khi c\u0103ng gh\u00e9p:<\/strong> Tr\u00e1nh t\u01b0 th\u1ebf du\u1ed7i ho\u00e0n to\u00e0n \u0111\u1ec3 kh\u00f4ng l\u00e0m qu\u00e1 h\u1ea1n ch\u1ebf kh\u1edbp [4].<\/li>\n<\/ol>\n

      Ngo\u00e0i ra, c\u1ea7n l\u01b0u \u00fd r\u1eb1ng m\u1ed9t s\u1ed1 k\u1ef9 thu\u1eadt PCL c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c h\u1ed7 tr\u1ee3 b\u1eb1ng n\u1ed9i soi \u0111\u1ec3 \u0111\u1ecbnh v\u1ecb \u1ed1ng, nh\u01b0ng tranh lu\u1eadn v\u1ec1 hi\u1ec7u qu\u1ea3 t\u01b0\u01a1ng \u0111\u1ed1i c\u1ee7a c\u00e1c ph\u01b0\u01a1ng ph\u00e1p v\u1eabn ti\u1ebfp di\u1ec5n [6]. Vi\u1ec7c lo\u1ea1i b\u1ecf meniscus trung t\u00e2m kh\u00f4ng ph\u1ea3i l\u00fac n\u00e0o c\u0169ng c\u1ea7n thi\u1ebft \u0111\u1ec3 \u0111\u1eb7t ch\u1ec9 kh\u00e2u \u1edf \u0111\u1ea7u distal c\u1ee7a d\u00e2y ch\u1eb1ng [7].<\/p>\n

      T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n
        \n
      • [1] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 2734<\/li>\n
      • [2] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 2732<\/li>\n
      • [3] Rockwood and Green's Fractures in Adults, 10th Edition, 2025, trang 1125<\/li>\n
      • [4] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 2734<\/li>\n
      • [5] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 2735<\/li>\n
      • [6] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 2732<\/li>\n
      • [7] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 2732<\/li>\n<\/ul>\n

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        Ph\u00e2n t\u00edch k\u1ef9 thu\u1eadt n\u1ed9i soi All-inside cho PCL, so s\u00e1nh hi\u1ec7u qu\u1ea3 m\u1ed9t b\u00f3 hay hai b\u00f3, c\u0169ng nh\u01b0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p khoan \u1ed1ng v\u00e0 c\u0103ng gh\u00e9p.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-575","post","type-post","status-publish","format-standard","hentry","category-noi-soi-khop"],"yoast_head":"\nN\u1ed9i soi t\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng ch\u00e9o sau b\u1eb1ng k\u1ef9 thu\u1eadt All-inside: Nguy\u00ean l\u00fd v\u00e0 Th\u1ef1c h\u00e0nh - BS NGUY\u1ec4N TH\u00c0NH LONG - BS C\u01a0 X\u01af\u01a0NG KH\u1edaP - CH\u1ea4N TH\u01af\u01a0NG CH\u1ec8NH H\u00ccNH<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/13\/noi-soi-tai-tao-day-chang-cheo-sau-bang-ky-thuat-all-inside-nguyen-ly-va-thuc-hanh\/\" \/>\n<meta property=\"og:locale\" content=\"vi_VN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"N\u1ed9i soi t\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng ch\u00e9o sau b\u1eb1ng k\u1ef9 thu\u1eadt All-inside: Nguy\u00ean l\u00fd v\u00e0 Th\u1ef1c h\u00e0nh - 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