Department of Orthopaedic Surgery, Medical Center of Chung-Ang University, Seoul, Republic of Korea.
Arthroscopy. 2011 Apr;27(4):507-15. doi: 10.1016/j.arthro.2010.11.007.
To evaluate functional results and knee stability after tensioning of remnant posterior cruciate ligament (PCL) with anterolateral (AL) bundle reconstruction and posterolateral corner (PLC) reconstruction in chronic PCL and PLC injuries.
Between March 2001 and March 2007, 95 patients with chronic PCL injuries combined with PLC injuries underwent tensioning of the remnant PCL with AL bundle reconstruction and PLC reconstruction. Among these 95 patients, 70 who were satisfied with our inclusion were reviewed. The mean follow-up period was 40.1 months (range, 24 to 96 months). Tensioning of remnant PCL fibers was performed by distal transfer of the posterior tibial attachment. The AL bundle of the PCL was reconstructed by use of the modified inlay technique. The PLC reconstructive procedure was performed with a single sling through fibular tunnel. Stability was measured on posterior stress radiographs and by use of a maximal manual displacement test performed with a KT-1000 arthrometer (MEDmetric, San Diego, CA). The International Knee Documentation Committee and Orthopädishe Arbeitsgruppe Knie scoring systems were used for clinical evaluation.
Stress radiographs showed that the mean side-to-side difference (posterior tibial translation compared with that of the contralateral knee) was reduced from 10.3 ± 2.4 mm preoperatively to 2.2 ± 1.5 mm at the last follow-up (P < .001), whereas the KT-1000 tests showed that this difference was reduced from 8.4 ± 2.2 mm preoperatively to 2.0 ± 1.4 mm (P < .001). The final International Knee Documentation Committee objective score was A in 30 patients (42.8%), B in 34 (48.6%), and C in 6 (8.6%). The mean Orthopädishe Arbeitsgruppe Knie score improved from 63.5 ± 10.4 to 88.9 ± 7.6 (P < .001).
Excellent posterior stability and relatively good clinical results were achieved with tensioning of the remnant PCL and AL bundle and PLC reconstruction by use of fibular tunnel for patients with chronic combined PCL-PLC injuries.
Level IV, case series.
评估慢性后交叉韧带（PCL）和后外侧角（PLC）损伤患者进行前外侧（AL）束重建和后外侧角重建后残余后交叉韧带（PCL）紧张的功能结果和膝关节稳定性。
2001 年 3 月至 2007 年 3 月，95 例慢性 PCL 损伤合并 PLC 损伤患者行残余 PCL 紧张术、AL 束重建和 PLC 重建。在这 95 例患者中，70 例对我们的纳入标准满意的患者接受了回顾性分析。平均随访时间为 40.1 个月（范围，24 至 96 个月）。通过胫骨后附着点的远端转移来进行残余 PCL 纤维的紧张。使用改良的嵌入式技术重建 PCL 的 AL 束。通过腓骨隧道的单个吊索进行 PLC 重建。通过后侧应力射线照相和使用 KT-1000 关节计（MEDmetric，圣地亚哥，CA）进行最大手动位移试验来测量稳定性。使用国际膝关节文献委员会和骨科膝关节评分系统进行临床评估。
应力射线照相显示，与对侧膝关节相比，平均侧-侧差异（胫骨后平移）从术前的 10.3 ± 2.4 毫米减少至末次随访时的 2.2 ± 1.5 毫米（P <.001），而 KT-1000 测试显示，差异从术前的 8.4 ± 2.2 毫米减少至 2.0 ± 1.4 毫米（P <.001）。最终的国际膝关节文献委员会客观评分 A 级 30 例（42.8%），B 级 34 例（48.6%），C 级 6 例（8.6%）。骨科膝关节评分从术前的 63.5 ± 10.4 分提高到 88.9 ± 7.6 分（P <.001）。
对于慢性 PCL-PLC 损伤患者，采用腓骨隧道对残余 PCL 和 AL 束及 PLC 进行紧张重建，可获得良好的后侧稳定性和相对较好的临床结果。
IV 级，病例系列。
