Shelbourne Knee Center, 1815 North Capitol Avenue, Indianapolis, IN 46202, USA.
Am J Sports Med. 2013 Jul;41(7):1526-33. doi: 10.1177/0363546513486771. Epub 2013 May 7.
Few studies report long-term subjective or objective results for acute, isolated posterior cruciate ligament (PCL) injuries in patients followed prospectively.
Subjective or objective results will not differ based on PCL laxity.
Case series; Level of evidence, 4.
Sixty-eight patients with an acute, isolated PCL injury were treated nonoperatively and followed prospectively with yearly subjective surveys and periodic objective evaluations. Physical examination included evaluation of range of motion, effusion, and quadriceps strength; radiographic grading of osteoarthritis; and measurements of joint space width. Subjective follow-up included the International Knee Documentation Committee (IKDC) and modified Cincinnati Knee Rating System (CKRS) surveys.
A total of 44 patients were available for both objective and subjective evaluations at a mean of 14.3 years (range, 10-21 years) after injury. All 68 patients underwent subjective follow-up at a mean of 17.6 years after injury. The mean quadriceps muscle strength was 97% of the noninvolved leg; all patients maintained normal knee range of motion. The overall grade of radiographs was rated as normal in 26 patients (59%), nearly normal in 13 patients (30%), abnormal in 4 patients (9%), and severely abnormal in 1 patient (2%). The grade of osteoarthritis on radiographs was not different in any knee compartment based on PCL laxity grade. Five patients (11%) had medial joint space narrowing greater than 2 mm. Mean IKDC and modified CKRS subjective scores at a mean of 17 years after injury were 73.4 ± 21.7 and 81.3 ± 17.4, respectively; there was no difference in subjective scores between PCL laxity grades. There was no difference in subjective scores between patients who completed a minimum 10-year objective follow-up and patients who completed surveys only.
Long-term results after an isolated PCL injury show that patients remain active, have good strength and full knee range of motion, and report good subjective scores. The prevalence of moderate to severe osteoarthritis was 11%. Results were not different based on PCL laxity grade. This natural history study of nonoperatively treated PCL injuries can serve as a baseline for comparison with patients treated with PCL reconstruction.
很少有研究报告前瞻性随访的急性、孤立性后交叉韧带（PCL）损伤患者的长期主观或客观结果。
PCL 松弛度不会导致主观或客观结果的差异。
病例系列；证据水平，4 级。
68 例急性、孤立性 PCL 损伤患者接受非手术治疗，并进行前瞻性随访，每年进行主观调查和定期客观评估。体格检查包括运动范围、渗出和股四头肌力量评估；骨关节炎的放射学分级；以及关节间隙宽度测量。主观随访包括国际膝关节文献委员会（IKDC）和改良辛辛那提膝关节评分系统（CKRS）调查。
共有 44 例患者在受伤后平均 14.3 年（10-21 年）时同时接受了客观和主观评估。68 例患者均在受伤后平均 17.6 年接受了主观随访。股四头肌肌力平均为健侧的 97%；所有患者均保持正常膝关节活动范围。放射学总体分级正常 26 例（59%），接近正常 13 例（30%），异常 4 例（9%），严重异常 1 例（2%）。根据 PCL 松弛度分级，膝关节任何关节间隙的关节炎分级均无差异。5 例（11%）患者内侧关节间隙狭窄>2mm。受伤后平均 17 年的平均 IKDC 和改良 CKRS 主观评分分别为 73.4±21.7 和 81.3±17.4，PCL 松弛度分级之间的主观评分无差异。完成至少 10 年客观随访的患者与仅完成调查的患者之间的主观评分无差异。
孤立性 PCL 损伤后的长期结果表明，患者保持活跃，具有良好的力量和完全的膝关节活动范围，并报告了良好的主观评分。中重度骨关节炎的患病率为 11%。结果与 PCL 重建治疗的患者不同。本研究为非手术治疗 PCL 损伤的自然史研究，可作为与 PCL 重建治疗患者进行比较的基线。
