Department of Orthopaedic Surgery, Division of Sports Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Arthroscopy. 2012 Oct;28(10):1454-63. doi: 10.1016/j.arthro.2012.04.141. Epub 2012 Aug 25.
The purpose of the study was to highlight our surgical technique of arthroscopic suture fixation for acute tibial eminence posterior cruciate ligament (PCL) avulsion fractures, clinical and radiographic outcomes, and complication rates.
This prospective study enrolled patients who had undergone arthroscopic reduction and suture fixation by use of 4 No. 5 Ethibond sutures (Ethicon, Somerville, NJ) for image-proven displaced PCL attachment fractures of the tibial eminence with posterior knee instability of grade II or higher. The mean follow-up period was 36 months (range, 24 to 45 months). Follow-up assessment included 3 different functional scores, KT-1000 arthrometry (MEDmetric, San Diego, CA), and radiographic evaluation.
The mean preoperative Lysholm score in the 36 patients was 35 (range, 26 to 55); the mean postoperative Lysholm score was 95 (range, 80 to 100). The mean preinjury and preoperative Tegner scores in the 36 patients were 7.4 ± 1.6 (range, 5 to 9) and 3.2 ± 1.5 (range, 2 to 5), respectively. The mean postoperative Tegner score was 7.0 ± 1.8 (range, 5 to 9). At the final follow-up, the International Knee Documentation Committee scores were observed to be normal (grade A) or nearly normal (grade B) in 33 patients (91.7%) and abnormal (grade C) in 3 patients (8.3%). All 36 fractures achieved union within 3 months. No significant complications such as arthrofibrosis, loss of initial fixation, or wound infection were noted.
Treatment of tibial PCL avulsion fractures by arthroscopic suture fixation is a successful technique to restore tibial avulsion injuries of the PCL with well-documented radiographic healing, good clinical outcomes, and low complication rates.
Level IV, therapeutic case series.
本研究旨在强调我们关节镜下缝合固定急性胫骨髁后交叉韧带（PCL）撕脱骨折的手术技术，以及临床和影像学结果和并发症发生率。
本前瞻性研究纳入了经关节镜复位和 4 根 No.5 Ethibond 缝线（Ethicon，Somerville，NJ）缝合固定证实有影像移位的 PCL 胫骨附丽撕脱骨折且膝关节后向不稳定程度为 II 级或更高级别的患者。平均随访时间为 36 个月（范围，24 至 45 个月）。随访评估包括 3 种不同的功能评分、KT-1000 关节测量仪（MEDmetric，圣地亚哥，CA）和影像学评估。
36 例患者的术前 Lysholm 评分平均为 35 分（范围，26 至 55 分）；术后 Lysholm 评分平均为 95 分（范围，80 至 100 分）。36 例患者术前和术前的 Tegner 评分分别为 7.4±1.6（范围，5 至 9）和 3.2±1.5（范围，2 至 5）。术后 Tegner 评分为 7.0±1.8（范围，5 至 9）。末次随访时，33 例（91.7%）患者国际膝关节文献委员会评分正常（A级）或接近正常（B 级），3 例（8.3%）患者评分异常（C 级）。所有 36 例骨折均在 3 个月内愈合。无明显并发症，如关节纤维化、初始固定丢失或伤口感染。
关节镜下缝线固定治疗胫骨 PCL 撕脱骨折是一种成功的技术，可以恢复 PCL 的胫骨撕脱损伤，影像学愈合良好，临床效果好，并发症发生率低。
IV 级，治疗性病例系列。
