Department of Trauma and Orthopaedic Surgery, Aintree University Hospital NHS Foundation Trust, Liverpool, England.
Department of Trauma and Orthopaedic Surgery, Royal Liverpool and Broadgreen University Teaching Hospitals, Liverpool, England.
Arthroscopy. 2014 Jul;30(7):811-7. doi: 10.1016/j.arthro.2014.02.039. Epub 2014 May 1.
To present a 5-year comparison of the functional outcomes of combined anterior cruciate ligament (ACL) and posterolateral corner (PLC) reconstruction with those of isolated ACL reconstruction.
All patients were reviewed clinically and completed knee function questionnaires prospectively, by use of the International Knee Documentation Committee (IKDC) 2000, Knee Injury and Osteoarthritis Outcome Score (KOOS), and Lysholm scoring systems, preoperatively and at 1, 2, and 5 years postoperatively. Patients who underwent combined ACL-PLC reconstruction were identified and reviewed. These patients had intact lateral collateral ligaments. A comparison group was created from a group of patients who underwent isolated ACL reconstruction. The ACL group was selected to have the same profile with regard to age, sex, and meniscal procedure.
There were 25 patients in the ACL-PLC group and 100 in the ACL group. All patients underwent restoration of their PLC function as shown on dial testing. The preoperative values for all KOOS measures and the Lysholm score were significantly lower in the ACL-PLC group than in the ACL group (P < .001). The IKDC score was not significantly different. All knee scores showed a significant improvement in both groups postoperatively at 1, 2, and 5 years (P < .001). At 5 years, the KOOS symptoms subscore (P < .001), KOOS pain subscore (P < .001), KOOS sports subscore (P < .001), KOOS quality-of-life subscore (P < .05), KOOS activities-of-daily living subscore (P < .001), aggregate score for all KOOS parameters (P < .001), and Lysholm score (P < .001) were significantly lower in the ACL-PLC group than in the ACL group. At 5 years, the IKDC scores were not significantly different. All patients in the ACL-PLC group resumed preinjury employment, and 23 of 25 had resumed sports.
Combined ACL-PLC injuries have greater morbidity than isolated ACL injuries. However, return to work and sporting activity is possible in most cases after combined ACL-PLC reconstruction. The KOOS for sport outcomes suggests that sports were resumed at lower functional levels.
Level III, case-control study.
比较前交叉韧带（ACL）联合后外侧角（PLC）重建与单纯 ACL 重建 5 年的功能结果。
所有患者均接受临床回顾，并前瞻性地使用国际膝关节文献委员会（IKDC）2000、膝关节损伤和骨关节炎结果评分（KOOS）和 Lysholm 评分系统，在术前和术后 1、2 和 5 年进行膝关节功能问卷评估。确定并回顾了接受 ACL-PLC 重建的患者。这些患者的外侧副韧带完整。通过 ACL 重建患者创建了一个比较组。ACL 组选择了与年龄、性别和半月板手术相同的患者。
ACL-PLC 组有 25 例，ACL 组有 100 例。所有患者的 PLC 功能均通过 Dial 测试得到恢复。ACL-PLC 组的所有 KOOS 测量值和 Lysholm 评分均显著低于 ACL 组（P <.001）。IKDC 评分无显著差异。两组术后 1、2 和 5 年的所有膝关节评分均显著改善（P <.001）。5 年后，KOOS 症状亚量表（P <.001）、KOOS 疼痛亚量表（P <.001）、KOOS 运动亚量表（P <.001）、KOOS 生活质量亚量表（P <.05）、KOOS 日常生活活动亚量表（P <.001）、所有 KOOS 参数综合评分（P <.001）和 Lysholm 评分（P <.001）在 ACL-PLC 组均显著低于 ACL 组。5 年后，IKDC 评分无显著差异。ACL-PLC 组所有患者均恢复受伤前的工作，25 例中有 23 例恢复运动。
ACL-PLC 联合损伤比单纯 ACL 损伤有更大的发病率。然而，大多数情况下，ACL-PLC 重建后可以恢复工作和运动活动。KOOS 运动结果表明，运动在较低的功能水平上恢复。
III 级，病例对照研究。
