Quan Songtao, Cai Litao, Yang Minglu
No.2 Department of Knee Injury, Luoyang Orthopedic-Traumatological Hospital, Henan Orthopedic Hospital, Luoyang Henan, 471000, P.R.China.
No.2 Department of Knee Injury, Luoyang Orthopedic-Traumatological Hospital, Henan Orthopedic Hospital, Luoyang Henan, 471000,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Aug 15;31(8):922-925. doi: 10.7507/1002-1892.201702026.
To evaluate the short-term effectiveness of a modified Laprade technique in the treatment of lateral multi-ligament injuries of knee by anatomical reconstruction of posterolateral complex (PLC) and anterior lateral ligament (ALL).
Between June 2013 and July 2015, 13 cases of lateral multi-ligament injuries of knee were treated. There were 9 males and 4 females with an average age of 38 years (range, 23-49 years). The injury was caused by traffic accident in 7 cases, falling from height in 4 cases, and sport injury in 2 cases. The time between injury and operation was 18-92 days (mean, 43 days). The results of anterior and posterior drawer tests and Lachmann test were positive, and all cases complicated by varus and external rotation instability. The Lysholm score of the knee was 38.4±7.7. According to International Knee Documentation Committee (IKDC) scoring, all were rated as grade D. According to Fanelli classification criteria, all were classified as type C. Anterior cruciate ligament, posterior cruciate ligament, PLC, and ALL were reconstructed simultaneously with autogenous tendon.
All incisions healed at stage I and no complication occurred. All patients were followed up 12-36 months (mean, 19 months). At last follow-up, the results of anterior and posterior drawer tests and Lachmann test were negative; 2 cases had varus instability, and 1 cases had external rotation instability. There was no anterior external rotation instability. The Lysholm score of the knee was 88.6 ±12.7, showing significant difference when compared with preoperative score ( =13.852, =0.000). According to IKDC scoring, 8 cases were rated as grade A, 4 as grade B, and 1 as grade C; significant difference was found when compared with preoperative value ( =3.182, =0.000).
In the treatment of lateral multi-ligament injuries knee, anatomical reconstruction of PLC and ALL with a modified Laprade technique can obtain good short-term effectiveness.
通过对后外侧复合体（PLC）和外侧副韧带（ALL）进行解剖重建，评估改良Laprade技术治疗膝关节外侧多发韧带损伤的短期疗效。
2013年6月至2015年7月，对13例膝关节外侧多发韧带损伤患者进行治疗。其中男性9例，女性4例，平均年龄38岁（范围23 - 49岁）。损伤原因：交通事故7例，高处坠落4例，运动损伤2例。受伤至手术时间为18 - 92天（平均43天）。前后抽屉试验及Lachmann试验结果均为阳性，所有病例均合并内翻及外旋不稳定。膝关节Lysholm评分为38.4±7.7。根据国际膝关节文献委员会（IKDC）评分，均为D级。按照Fanelli分类标准，均为C型。采用自体肌腱同期重建前交叉韧带、后交叉韧带、PLC及ALL。
所有切口均Ⅰ期愈合，无并发症发生。所有患者均获随访，随访时间12 - 36个月（平均19个月）。末次随访时，前后抽屉试验及Lachmann试验结果均为阴性；2例存在内翻不稳定，1例存在外旋不稳定。无前外侧旋转不稳定。膝关节Lysholm评分为88.6±12.7，与术前评分比较差异有统计学意义（ =13.852， =0.000）。根据IKDC评分，8例为A级，4例为B级，1例为C级；与术前比较差异有统计学意义（ =3.182， =0.000）。
在治疗膝关节外侧多发韧带损伤时，采用改良Laprade技术对PLC和ALL进行解剖重建可获得良好的短期疗效。
