Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Knee Surg Sports Traumatol Arthrosc. 2013 May;21(5):1023-8. doi: 10.1007/s00167-011-1769-5. Epub 2011 Nov 25.
The purpose of this study was to examine a developed surgical technique by performing a mid-term evaluation of clinical and stability results and complications.
Thirty patients who underwent transtibial posterior cruciate ligament (PCL) reconstruction using a bioabsorbable cross-pin tibial back side fixation method were enrolled in this prospective study. Lysholm and International Knee Documentation Committee (IKDC) knee scales were used to evaluate clinical outcomes. Stability was evaluated using a Telos device with a 150 N force at 90 degrees of knee flexion. Follow-up magnetic resonance imaging (MRI) was also performed in 20 (66.7%) patients, and complications were evaluated. Those with complication by MRI were assigned to an abnormal MRI group.
The follow-up period was 47 (range, 25-62) months. On comparing preoperative and final follow-up clinical results, Lysholm and IKDC knee scale scores were found to have improved significantly (P < 0.001). The mean side-to-side difference in posterior translation measured using a Telos device was 13.4 ± 3.1 mm (range 10-20 mm) preoperatively and 3.2 ± 1.5 mm (range 1-7 mm) at last follow-up, which represented a significant improvement in stability (P < 0.001). Five patients showed cyst formation in the tibial tunnel and two patients showed a significant signal increase at the anterior portion of the tibial tunnel, which was believed to indicate a pro-cystic status. The normal and abnormal MRI groups had similar Lysholm and IKDC knee scale scores and stress radiographs (P > 0.05).
Single-bundle transtibial PCL reconstruction using a bioabsorbable cross-pin tibial back side fixation was found to produce satisfactory clinical and stability results. However, despite these satisfactory results, a potential complication of tibial cyst formation was observed.
Case series, Level IV.
本研究旨在通过对临床和稳定性结果及并发症进行中期评估，检验一种已开发的手术技术。
本前瞻性研究纳入了 30 例接受经胫骨后内侧入路生物可吸收交叉钉固定的后交叉韧带（PCL）重建术的患者。采用 Lysholm 和国际膝关节文献委员会（IKDC）膝关节评分评估临床结果，采用 Telos 设备在膝关节屈曲 90°时施加 150N 的力评估稳定性。20 例（66.7%）患者还进行了随访磁共振成像（MRI）检查，并评估了并发症。通过 MRI 发现并发症的患者被分配到异常 MRI 组。
随访时间为 47（25-62）个月。与术前相比，最终随访时 Lysholm 和 IKDC 膝关节评分均显著改善（P<0.001）。使用 Telos 设备测量的后向平移侧别差值，术前平均为 13.4±3.1mm（范围 10-20mm），末次随访时为 3.2±1.5mm（范围 1-7mm），稳定性显著改善（P<0.001）。5 例患者胫骨隧道内出现囊肿形成，2 例患者胫骨隧道前部分出现明显信号增高，提示存在潜在的囊状病变。正常 MRI 组和异常 MRI 组的 Lysholm 和 IKDC 膝关节评分和应力位 X 线片相似（P>0.05）。
经胫骨后内侧入路的生物可吸收交叉钉固定的单束 PCL 重建可获得满意的临床和稳定性结果，但尽管结果满意，仍观察到胫骨囊肿形成的潜在并发症。
病例系列，IV 级。
