Dennis Michael G, Fox Jeff A, Alford J Winslow, Hayden Jennifer K, Bach Bernard R
Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Ill, USA.
J Knee Surg. 2004 Jul;17(3):133-9. doi: 10.1055/s-0030-1248211.
A survey was conducted of the Herodicus Society membership to assess the current status of treating posterior cruciate ligament (PCL) injuries and compared to a similar survey conducted in 1991. The survey addressed indications, graft choice, surgical technique, graft tensioning, and graft fixation. Seventy-eight active surgeons were sent a 34-question survey pertaining to isolated PCL injuries. The majority of respondents (78%) performed < or = 10 PCL reconstructions per year. The arthroscopic assisted with posteromedial portal technique was the most commonly used (49%). The tibial inlay/onlay technique was used by 15%, and 68% used the single femoral tunnel technique. The remainder used a double femoral tunnel technique. Allograft Achilles tendon was the most commonly selected graft for acute (43%) and chronic (50%) PCL reconstructions. An interference screw for femoral fixation was used 67% of the time. The majority of respondents (55%) tensioned their single bundle or anterolateral band of a double bundle in 71 degrees-90 degrees of flexion. A significant difference in technique was noted when comparing those who performed < or = 10 PCL reconstructions per year (group 1) versus > 10 PCL reconstructions per year (group 2). In group 1, 25% of surgeons used a double tunnel technique versus 59% of surgeons in group 2. The most common operative treatment for PCL injuries consisted of a single femoral tunnel with an Achilles tendon allograft. When compared to a similar survey conducted in 1991, the notable differences were a trend toward Achilles tendon allograft and the popularization of the double femoral tunnel and tibial inlay/onlay technique.
对希罗迪科斯协会会员进行了一项调查，以评估后交叉韧带（PCL）损伤的当前治疗状况，并与1991年进行的类似调查进行比较。该调查涉及手术指征、移植物选择、手术技术、移植物张紧和移植物固定。向78名活跃的外科医生发送了一份关于孤立PCL损伤的34个问题的调查问卷。大多数受访者（78%）每年进行≤10例PCL重建手术。关节镜辅助后内侧入路技术是最常用的（49%）。15%的人使用胫骨嵌体/覆盖技术，68%的人使用单股隧道技术。其余的人使用双股隧道技术。同种异体跟腱是急性（43%）和慢性（50%）PCL重建中最常选择的移植物。67%的时间使用干涉螺钉进行股骨固定。大多数受访者（55%）在屈膝71度至90度时对单束或双束的前外侧束进行张紧。在比较每年进行≤10例PCL重建手术的医生（第1组）和每年进行>10例PCL重建手术的医生（第2组）时，注意到技术上存在显著差异。在第1组中，25%的外科医生使用双隧道技术，而在第2组中这一比例为59%。PCL损伤最常见的手术治疗方法是采用单股隧道和同种异体跟腱。与1991年进行的类似调查相比，显著差异在于同种异体跟腱的使用趋势以及双股隧道和胫骨嵌体/覆盖技术的普及。
