Sekiya Jon K, West Robin V, Ong Bernard C, Irrgang James J, Fu Freddie H, Harner Christopher D
Bone and Joint/Sports Medicine Institute, Uniformed Health Services University of the Health Sciences, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA.
Arthroscopy. 2005 Sep;21(9):1042-50. doi: 10.1016/j.arthro.2005.05.023.
The purpose of this study was to evaluate the clinical outcomes after arthroscopic single-bundle posterior cruciate ligament (PCL) reconstruction in patients with isolated grade III PCL injuries.
Retrospective review.
Twenty-one patients who underwent an isolated arthroscopic single-bundle PCL reconstruction for the treatment of a grade III PCL injury between 1989 and 1998 were included in the study. There were 15 male and 6 female patients with an average age of 38 years (range, 20 to 62 years). The length of follow-up was 5.9 years (range, 2.6 to 11 years), and the average time from injury to surgery was 4.5 years (median, 1.3 years; range, 2 weeks to 25 years). All patients completed a subjective evaluation and 14 patients returned for a physical examination and radiographs. One patient underwent an acute reconstruction (<3 weeks), 4 had a subacute (<3 months), and 16 underwent a chronic (>3 months) reconstruction. The anterolateral bundle of the PCL was reconstructed using an Achilles tendon allograft passed through femoral and tibial bone tunnels.
The overall average Activities of Daily Living Scale (ADLS), Sports Activities Scale (SAS), and SF-36 scores were 79.3, 71.6, and 98 points, respectively. There was a significant difference identified when the ADLS (91.3 v 75.6) and the SAS (90.4 v 65.8) scores of the subacute/acute group were compared with those of the chronic reconstruction group. Using the International Knee Documentation Committee (IKDC) subjective assessment, 57% of the patients had normal/near normal knee function, and 62% had a normal/near normal activity level. The average extension and flexion losses were 1 degrees and 5 degrees , respectively. Instrumented laxity examination revealed that 62% had less than a 3-mm and 31% had a 3- to 5-mm side-to-side difference in corrected posterior displacement. Radiographs at follow-up showed that 75% had normal/near normal findings according to IKDC guidelines.
The clinical outcomes after arthroscopic single-bundle PCL reconstruction in this study produced a satisfactory return of function and improvement in symptoms. All patients in this study had improved laxity of at least 1 grade. When compared with chronic reconstructions, acute reconstructions had statistically significant better ADLS and SAS scores.
IV, case series.
本研究旨在评估关节镜下单束后交叉韧带（PCL）重建治疗单纯III级PCL损伤患者的临床疗效。
回顾性研究。
本研究纳入了1989年至1998年间接受关节镜下单束PCL重建治疗III级PCL损伤的21例患者。其中男性15例，女性6例，平均年龄38岁（范围20至62岁）。随访时间为5.9年（范围2.6至11年），受伤至手术的平均时间为4.5年（中位数1.3年；范围2周至25年）。所有患者均完成了主观评估，14例患者返回进行体格检查和影像学检查。1例患者接受了急性重建（<3周），4例为亚急性重建（<3个月），16例接受了慢性重建（>3个月）。采用经股骨和胫骨骨隧道的跟腱同种异体移植物重建PCL前外侧束。
日常生活活动量表（ADLS）、体育活动量表（SAS）和SF-36总分的总体平均值分别为79.3分、71.6分和98分。亚急性/急性组的ADLS评分（91.3对75.6）和SAS评分（90.4对65.8）与慢性重建组相比存在显著差异。根据国际膝关节文献委员会（IKDC）主观评估，57%的患者膝关节功能正常/接近正常，62%的患者活动水平正常/接近正常。平均伸直和屈曲丧失分别为1°和5°。仪器化松弛度检查显示，62%的患者校正后移位的侧方差异小于3mm，31%的患者为3至5mm。随访时的X线片显示，根据IKDC指南，75%的患者结果正常/接近正常。
本研究中关节镜下单束PCL重建后的临床疗效使功能恢复满意，症状改善。本研究中的所有患者松弛度至少改善了1级。与慢性重建相比，急性重建的ADLS和SAS评分在统计学上有显著更好的结果。
IV，病例系列。
Zotero 插件