Wu Chin-Hsien, Chen Alvin Chao-Yu, Yuan Li-Jen, Chang Chung-Hsun, Chan Yi-Sheng, Hsu Kuo-Yao, Wang Ching-Jen, Chen Wen-Jer
Department of Orthopaedic Surgery and Chang-Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan, Republic of China.
Arthroscopy. 2007 Apr;23(4):420-7. doi: 10.1016/j.arthro.2006.12.011.
We prospectively assessed 22 consecutively treated patients to determine the effectiveness and safety of arthroscopically assisted posterior cruciate ligament (PCL) reconstruction by using a quadriceps tendon autograft.
Twenty-two patients with isolated PCL injury who underwent PCL reconstruction with a quadriceps tendon autograft were enrolled in the prospective study. The average follow-up period was 66 months (range, 60-76). Follow-up included Lysholm knee scores, Tegner activity scores, International Knee Documentation Committee (IKDC) score, thigh muscle assessment, and radiographic assessment.
The mean preoperative Lysholm score for 22 knees was 67 (range, 50 to 75), and the mean postoperative Lysholm score was 89 (range, 75 to 98). Nineteen of 22 patients (86%) displayed good or excellent results in the final assessment. The mean preoperative Tegner score for 22 knees was 3 (range, 2 to 5), whereas the mean postoperative Tegner score was 6 (range, 3 to 9). There were statistically significant improvements in Lysholm score (P = .009), Tegner score (P = .039), postoperative KT-1000 arthrometer (MEDmetric, San Diego, CA) scores (P = .006), final IKDC rating (P = .035), and thigh atrophy and muscle strength (P < .05) when compared with preoperative data. Regarding IKDC final rating, 82% of the patients (18 of 22) were assessed as normal or nearly normal (grade A or B).
After follow-up for more than 60 months, the analytical results showed patients achieved satisfactory function after PCL reconstruction by using a quadriceps tendon-patellar bone autograft. This study suggests that a quadriceps tendon autograft is sufficiently large and strong and can achieve good ligament function after reconstruction.
Level IV, therapeutic study.
我们前瞻性地评估了22例连续接受治疗的患者，以确定采用股四头肌肌腱自体移植进行关节镜辅助后交叉韧带（PCL）重建的有效性和安全性。
22例孤立性PCL损伤患者接受了股四头肌肌腱自体移植PCL重建，并纳入前瞻性研究。平均随访期为66个月（范围60 - 76个月）。随访包括Lysholm膝关节评分、Tegner活动评分、国际膝关节文献委员会（IKDC）评分、大腿肌肉评估和影像学评估。
22个膝关节术前Lysholm评分的平均值为67（范围50至75），术后Lysholm评分的平均值为89（范围75至98）。22例患者中有19例（86%）在最终评估中显示出良好或优异的结果。22个膝关节术前Tegner评分的平均值为3（范围2至5），而术后Tegner评分的平均值为6（范围3至9）。与术前数据相比，Lysholm评分（P = 0.009）、Tegner评分（P = 0.039）、术后KT - 1000关节测量仪（MEDmetric，圣地亚哥，加利福尼亚州）评分（P = 0.006）、最终IKDC评级（P = 0.035）以及大腿萎缩和肌肉力量（P < 0.05）均有统计学上的显著改善。关于IKDC最终评级，82%的患者（22例中的18例）被评估为正常或接近正常（A级或B级）。
随访超过60个月后，分析结果表明，患者采用股四头肌肌腱 - 髌骨骨自体移植进行PCL重建后功能恢复令人满意。本研究表明，股四头肌肌腱自体移植足够大且强壮，重建后可实现良好的韧带功能。
IV级，治疗性研究。
