Eguchi A, Adachi N, Nakamae A, Usman M A, Deie M, Ochi M
Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, 734-8551 Hiroshima, Japan.
Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, 734-8551 Hiroshima, Japan.
Orthop Traumatol Surg Res. 2014 May;100(3):303-8. doi: 10.1016/j.otsr.2013.12.020. Epub 2014 Mar 25.
Posterior cruciate ligament (PCL) reconstruction using the remnant preserving technique may contribute to improved postoperative posterior stability, graft healing, and proprioception recovery. Although there have been several reports on remnant preserving PCL reconstruction, no study has yet evaluated the proprioceptive functions before and after PCL reconstruction with remnant preservation. The purpose of this study is to retrospectively evaluate the clinical outcomes and proprioceptive function after isolated single-bundle PCL reconstruction with remnant preservation for chronic PCL injuries.
Isolated single-bundle PCL reconstruction with remnant preservation surgery for chronic PCL injuries provides satisfactory clinical outcomes and good recovery of the proprioceptive function.
Nineteen patients who had undergone isolated single-bundle PCL reconstruction with remnant preservation for chronic PCL injuries were followed up for more than 2 years. The posterior laxity was measured by the gravity sag view, stress radiography and the KT-2000 knee arthrometer. The proprioceptive function was defined as the threshold to detect passive motion (TTDPM).
The average Lysholm score significantly improved from 63.7±13.2 preoperatively to 94.4±4.6 at final follow-up. The postoperative posterior laxity significantly improved. Regarding TTDPM, there were no significant differences between the preoperative score and the score at every given time point, regardless of the starting angles and the moving directions of the knees.
The proprioceptive function, defined as TTDPM, is maintained after single-bundle PCL reconstruction with remnant preservation, and the postoperative clinical scores and posterior laxity significantly improve.
Level IV, therapeutic case series.
采用保留残端技术进行后交叉韧带（PCL）重建可能有助于改善术后的后向稳定性、移植物愈合及本体感觉恢复。尽管已有多篇关于保留残端的PCL重建的报道，但尚无研究评估保留残端的PCL重建术前和术后的本体感觉功能。本研究的目的是回顾性评估采用保留残端技术对慢性PCL损伤进行孤立单束PCL重建后的临床疗效和本体感觉功能。
采用保留残端手术对慢性PCL损伤进行孤立单束PCL重建可提供满意的临床疗效并使本体感觉功能得到良好恢复。
对19例采用保留残端技术对慢性PCL损伤进行孤立单束PCL重建的患者进行了2年以上的随访。通过重力垂距视图、应力位X线片和KT-2000膝关节测压仪测量后向松弛度。本体感觉功能定义为检测被动运动的阈值（TTDPM）。
Lysholm平均评分从术前的63.7±13.2显著提高至末次随访时的94.4±4.6。术后后向松弛度显著改善。关于TTDPM，无论膝关节的起始角度和运动方向如何，术前评分与每个给定时间点的评分之间均无显著差异。
以TTDPM定义的本体感觉功能在采用保留残端技术进行单束PCL重建后得以维持，且术后临床评分和后向松弛度显著改善。
IV级，治疗性病例系列。
