Mygind-Klavsen Bjarne, Nielsen Torsten Grønbech, Lind Martin Carøe
Department of Sports Traumatology, Aarhus University Hospital, Aarhus, Demark.
Orthop J Sports Med. 2017 Apr 10;5(4):2325967117700077. doi: 10.1177/2325967117700077. eCollection 2017 Apr.
Posterior cruciate ligament (PCL) reconstructions are rarely performed compared with that for the anterior cruciate ligament (ACL).
To evaluate the clinical and functional outcome after isolated or multiligament PCL reconstruction.
Cohort study; Level of evidence, 3.
Patients who underwent PCL reconstruction between 2002 and 2010 were included. Standardized follow-up was performed between 2012 and 2013 and consisted of subjective scores (Tegner activity score, Knee injury and Osteoarthritis Outcome Score [KOOS], and subjective International Knee Documentation Committee [IKDC] score) and objective measures, including knee laxity (KT-1000), extension strength, and overall IKDC score.
One hundred ninety-six patients were identified, of which 172 were available for postoperative follow-up: 39.3% with isolated PCL and 60.7% with multiligament injury. One hundred ten patients were available to complete both clinical follow-up and subjective questionnaires; 62 patients returned the subjective questionnaires. Mean follow-up was 5.9 years (range, 3.1-9.7 years). KOOS scores at follow-up in the isolated PCL group by subscale were 74 (symptoms), 76 (pain), 80 (activities of daily living), 55 (sport), and 55 (quality of life). Scores for patients in the multiligament group were 73 (symptoms), 79 (pain), 82 (activities of daily living), 53 (sport), and 56 (quality of life). Tegner scores were 4.5 and 4.4, respectively, and subjective IKDC scores were 63.8 and 65.0. The mean side-to-side difference in knee laxity was 2.7 mm in the isolated PCL group compared with 2.8 mm in the multiligament group. At 1-year follow-up there were significant differences in KOOS outcome scores between the isolated PCL subgroup and the multiligament subgroup, but no differences at final follow-up. Twelve patients (5%) had PCL revision surgery within the follow-up period.
Despite the type of injury, there were only minor differences in knee laxity and subjective outcome scores between the isolated PCL group and the multiligament group. The overall revision rate in this study was 5.2%.
与前交叉韧带（ACL）重建相比，后交叉韧带（PCL）重建很少进行。
评估孤立性或多韧带PCL重建后的临床和功能结果。
队列研究；证据水平，3级。
纳入2002年至2010年间接受PCL重建的患者。2012年至2013年进行标准化随访，包括主观评分（Tegner活动评分、膝关节损伤和骨关节炎疗效评分[KOOS]以及主观国际膝关节文献委员会[IKDC]评分）和客观测量，包括膝关节松弛度（KT-1000）、伸展力量和整体IKDC评分。
共确定196例患者，其中172例可进行术后随访：孤立性PCL损伤患者占39.3%，多韧带损伤患者占60.7%。110例患者可完成临床随访和主观问卷调查；62例患者返回了主观问卷。平均随访时间为5.9年（范围3.1 - 9.7年）。孤立性PCL组随访时KOOS各子量表评分分别为：症状74分、疼痛76分、日常生活活动80分、运动55分、生活质量55分。多韧带组患者的评分分别为：症状73分、疼痛79分、日常生活活动82分、运动53分、生活质量56分。Tegner评分分别为4.5分和4.4分，主观IKDC评分分别为63.8分和65.0分。孤立性PCL组膝关节松弛度的平均左右差异为2.7 mm，多韧带组为2.8 mm。在1年随访时，孤立性PCL亚组和多韧带亚组之间的KOOS结果评分存在显著差异，但最终随访时无差异。12例患者（5%）在随访期间接受了PCL翻修手术。
尽管损伤类型不同，但孤立性PCL组和多韧带组在膝关节松弛度和主观结果评分方面仅有微小差异。本研究中的总体翻修率为5.2%。
