Kim Sung-Jae, Chang Ji-Hoon, Oh Kyung-Soo
Department of Orthopaedic Surgery, Yonsei University Health System, Shinchon-Dong, Seoul, Korea.
Clin Orthop Relat Res. 2009 Jan;467(1):260-6. doi: 10.1007/s11999-008-0554-3. Epub 2008 Oct 9.
Generalized joint laxity has been considered a risk factor causing late failure of reconstructed anterior cruciate ligaments, although it is unknown whether that is the case for reconstructed posterior cruciate ligaments. We hypothesized patients with generalized joint laxity, compared with those without laxity, would have similar postoperative knee stability, range of motion, and functional scores after posterior cruciate ligament reconstruction. The Beighton and Horan criteria were used to determine generalized joint laxity. We enrolled 24 patients with generalized joint laxity (Group L) and 29 patients without any positive findings of joint laxity (Group N) matched by gender and age. The average side-by-side differences of posterior tibial translation were 4.72 mm in Group L and 3.63 mm in Group N. We observed no differences in posterior tibial translation with differing graft materials or combined procedures. In Group L the International Knee Documentation Committee score was normal in 12.5% and nearly normal in 45.8% whereas in Group N, 24.1% were normal and 55.2% nearly normal. Patients with generalized joint laxity showed more posterior laxity than patients without joint laxity. Generalized joint laxity therefore appears to be a risk factor associated with posterior laxity after posterior cruciate ligament reconstruction.
Level III, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
尽管对于重建后交叉韧带是否如此尚不清楚,但全身关节松弛一直被认为是导致重建前交叉韧带晚期失败的一个风险因素。我们假设,与无关节松弛的患者相比,全身关节松弛的患者在进行后交叉韧带重建术后,膝关节稳定性、活动范围和功能评分相似。采用贝顿和霍兰标准来确定全身关节松弛情况。我们纳入了24例全身关节松弛的患者(L组)和29例关节松弛无任何阳性发现的患者(N组),两组在性别和年龄上相匹配。L组胫骨后移的平均双侧差异为4.72mm,N组为3.63mm。我们观察到不同移植物材料或联合手术在胫骨后移方面无差异。L组中,国际膝关节文献委员会评分正常的占12.5%,接近正常的占45.8%;而在N组中,正常的占24.1%,接近正常的占55.2%。全身关节松弛的患者比无关节松弛的患者表现出更多的后向松弛。因此,全身关节松弛似乎是后交叉韧带重建术后与后向松弛相关的一个风险因素。
III级,预后研究。有关证据水平的完整描述,请参阅作者指南。