Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue, R200, Minneapolis, MN 55454, USA.
J Bone Joint Surg Am. 2010 Jan;92(1):16-22. doi: 10.2106/JBJS.I.00474.
Chronic posterolateral knee injuries often result in substantial patient morbidity and functional instability. The clinical stability and functional outcomes following anatomic reconstructions in patients with a chronic posterolateral knee injury have not been determined, to our knowledge.
A two-center outcomes study of sixty-four patients with grade-3 chronic posterolateral instability was performed. The patients were evaluated subjectively with the modified Cincinnati and International Knee Documentation Committee (IKDC) subjective scores and objectively with the IKDC objective score.
Eighteen patients had an isolated posterolateral knee reconstruction, and forty-six patients underwent a single-stage multiple-ligament reconstruction that included reconstruction of one or both cruciate ligaments along with the posterolateral knee reconstruction. The average duration of follow-up was 4.3 years. The fifty-four patients who were available for follow-up had an average total Cincinnati score of 65.7 points. A significant improvement was found between the preoperative and postoperative IKDC objective scores for varus opening at 20 degrees, external rotation at 30 degrees, reverse pivot shift, and single-leg hop.
An anatomic posterolateral reconstruction resulted in improved clinical outcomes and objective stability for patients with a grade-3 posterolateral knee injury.
慢性后外侧膝关节损伤常导致患者出现严重的疾病和功能不稳定。据我们所知，对于慢性后外侧膝关节损伤患者，解剖重建后的临床稳定性和功能结果尚未确定。
对 64 例 3 级慢性后外侧不稳定患者进行了一项双中心结局研究。患者采用改良的辛辛那提和国际膝关节文献委员会（IKDC）主观评分进行主观评估，采用 IKDC 客观评分进行客观评估。
18 例患者行单纯后外侧膝关节重建，46 例行单阶段多韧带重建，包括重建 1 或 2 条交叉韧带和后外侧膝关节重建。平均随访时间为 4.3 年。54 例可随访的患者平均 Cincinnati 总分为 65.7 分。术前和术后 IKDC 客观评分在 20 度内翻、30 度外旋、反向旋转试验和单腿跳跃试验中均发现明显改善。
解剖后外侧重建可改善 3 级后外侧膝关节损伤患者的临床结果和客观稳定性。
