Jung Young-Bok, Lee Yong Seuk, Jung Ho-Joong, Nam Chang-Hyun
Department of Orthopaedics, Chung-Ang University Medical Center, Seoul, Korea.
Arthroscopy. 2009 Mar;25(3):257-61. doi: 10.1016/j.arthro.2008.10.007. Epub 2008 Nov 28.
This study examined the effect of the anteroposterior (AP) direction force on the tibial external rotation of a posterior cruciate ligament (PCL)/posterolateral corner (PLC)-deficient knee in a clinical setting.
Between December 2006 and December 2007, 21 patients with a PCL-PLC injury were assessed using a dial test. The thigh-foot angle (TFA) and patella-tubercle angle (PTA) were measured with an external rotation stress applied to the tibia at both 30 degrees and 90 degrees of knee flexion in 2 different positions (reduced and posterior subluxed). The test was performed with the patient in the supine position and with an AP force applied to the tibia by an assistant. To reduce intra- and interobserver bias, the measurements were taken twice by 2 orthopaedic surgeons for all patients.
In the subluxed position, the mean side-to-side differences in the TFA at 30 degrees and 90 degrees knee flexion were 12.6 degrees +/- 2.0 degrees and 12.3 degrees +/- 1.4 degrees , respectively. In the reduced position, the mean side-to-side differences in the TFA at 30 degrees and 90 degrees knee flexion were 18.4 degrees +/- 1.4 degrees and 18.5 degrees +/- 1.5 degrees , respectively. In the subluxed position, the mean side-to-side differences in the PTA at 30 degrees and 90 degrees knee flexion were 9.1 degrees +/- 0.8 degrees and 9.0 degrees +/- 0.7 degrees , respectively. In the reduced position, the mean side-to-side differences in the PTA at 30 degrees and 90 degrees knee flexion were 13.3 degrees +/- 0.6 degrees and 13.2 degrees +/- 0.6 degrees , respectively.
The reduction of a posteriorly subluxed knee increased the tibial external rotation (TFA and PTA) during the dial test of combined PCL-PLC injuries in a clinical setting. The accuracy of the dial test may help present surgeons from missing a combined PLC injury that should be corrected in a PCL deficient knee.
Level I, testing of previously developed diagnostic criteria in series of consecutive patients.
本研究在临床环境中检测了前后（AP）方向力对后交叉韧带（PCL）/后外侧角（PLC）损伤膝关节胫骨外旋的影响。
在2006年12月至2007年12月期间，对21例PCL - PLC损伤患者进行了表盘试验评估。在膝关节屈曲30度和90度时，于2种不同位置（复位和后脱位）对胫骨施加外旋应力，测量大腿 - 足部角度（TFA）和髌骨 - 结节角度（PTA）。试验在患者仰卧位时进行，助手对胫骨施加AP力。为减少观察者内和观察者间偏差，2名骨科医生对所有患者的测量均进行了2次。
在脱位位置，膝关节屈曲30度和90度时TFA的平均左右差异分别为12.6度±2.0度和12.3度±1.4度。在复位位置，膝关节屈曲30度和9度时TFA的平均左右差异分别为18.4度±1.4度和18.5度±1.5度。在脱位位置，膝关节屈曲30度和90度时PTA的平均左右差异分别为9.1度±0.8度和度±0.7度。在复位位置，膝关节屈曲30度和90度时PTA的平均左右差异分别为13.3度±0.6度和13.2度±0.6度。
在临床环境中，后脱位膝关节的复位增加了PCL - PLC联合损伤表盘试验期间的胫骨外旋（TFA和PTA）。表盘试验的准确性可能有助于外科医生避免漏诊PCL损伤膝关节中应纠正的合并PLC损伤。
I级，在一系列连续患者中对先前制定的诊断标准进行测试。
Zotero 插件