Helito Camilo Partezani, Bonadio Marcelo Batista, Demange Marco Kawamura, da Mota e Albuquerque Roberto Freire, Pécora José Ricardo, Camanho Gilberto Luis, Angelini Fabio Janson
Department of Orthopaedics and Traumatology, Faculty of Medicine, University of São Paulo, 05403-010, São Paulo, Brazil,
Int Orthop. 2015 Mar;39(3):543-8. doi: 10.1007/s00264-014-2576-7. Epub 2014 Nov 7.
A technique for combined reconstruction of the anterior cruciate ligament (ACL) and posterolateral corner (PLC) with a single femoral tunnel was recently described. This technique aims to avoid tunnel confluence in the lateral femoral condyle. Because there have been no studies on the functional outcomes and possible complications of this technique, our goal is to demonstrate a two-year minimum follow-up of patients who underwent this type of reconstruction.
Nine patients were prospectively evaluated. The ACL was reconstructed with an anatomic single bundle, and the PLC structures reconstructed were the lateral collateral ligament, the popliteus tendon, and the popliteofibular ligament. Patients were evaluated using the objective and subjective International Knee Documentation Committee (IKDC) and the Lysholm and Tegner scales before and after the surgical procedure.
The mean follow-up period of the studied patients was 27.3 months. The mean subjective IKDC score rose from 43.6 to 84.0, and the Lysholm score rose from 62.1 to 90.8. In the final assessment, six patients were classified as IKDC A and three as IKDC B. According to the Tegner scale, five patients were able to return to their level of activity prior to the injury. There were no reconstruction failures. One patient experienced postoperative infection and pain in the lateral scar.
The results of the reconstruction of ACL injuries associated with PLC with a single femoral tunnel produced a good functional outcome and a low incidence of complications.
最近描述了一种用单个股骨隧道联合重建前交叉韧带(ACL)和后外侧角(PLC)的技术。该技术旨在避免股骨外侧髁隧道融合。由于尚未有关于该技术功能结果和可能并发症的研究,我们的目标是展示接受此类重建患者至少两年的随访情况。
对9例患者进行前瞻性评估。采用解剖单束重建ACL,重建的PLC结构包括外侧副韧带、腘肌腱和腘腓韧带。手术前后使用客观和主观的国际膝关节文献委员会(IKDC)以及Lysholm和Tegner量表对患者进行评估。
研究患者的平均随访期为27.3个月。主观IKDC评分平均从43.6升至84.0,Lysholm评分从62.1升至90.8。在最终评估中,6例患者被归类为IKDC A级,3例为IKDC B级。根据Tegner量表,5例患者能够恢复到受伤前的活动水平。没有重建失败的情况。1例患者术后出现感染和外侧瘢痕疼痛。
采用单个股骨隧道重建与PLC相关的ACL损伤,结果显示功能良好且并发症发生率低。