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PCL指数在自体腘绳肌腱重建前交叉韧带中的临床相关性。

The clinical relevance of PCL index on the reconstruction of anterior cruciate ligament with hamstring tendon autograft.

作者信息

Pombo Bruno, Ferreira Ana Cristina, Marques Pedro

机构信息

Orthopaedics Department, Unidade Local de Saúde do Alto Minho, Viana do Castelo, Portugal.

Mathematics Department, Minho University, Braga, Portugal.

出版信息

Eur J Orthop Surg Traumatol. 2019 Jan;29(1):111-117. doi: 10.1007/s00590-018-2292-x. Epub 2018 Aug 12.

DOI:10.1007/s00590-018-2292-x
PMID:30101360
Abstract

The posterior cruciate ligament index (PCL index) has been reported as a diagnostic and prognostic marker for anterior cruciate ligament (ACL) reconstruction. The clinical relevance of PCL index on the reconstruction of ACL with hamstring tendon autograft has not been described in the literature. The objective of this study is to evaluate the importance of the PCL index as a marker of anatomic reconstruction and of functional improvement of patients undergoing ACL reconstruction with HT autograft. Twenty-four patients were submitted to ACL reconstruction with HT autograft. The PCL index was assessed by magnetic resonance imaging before and after surgery. The functional evaluation was performed through the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form© and Knee Society Knee Scoring System© (IKS). Patients presented a significant positive variation of the PCL index, IKDC and IKS scores. There is no significant correlation between PCL index variation and IKDC and IKS scores (p > 0.05). Unlike other studies reporting a relationship between the PCL index, control of rotational kinematics, and functional improvement in patients undergoing ACL reconstruction with bone-patellar tendon-bone autograft, this study does not demonstrate this association. There is evidence in this study to show that the PCL index may be used as an anatomic reconstructive marker of ACL but not to predict the clinical outcome in this type of reconstruction.

摘要

后交叉韧带指数(PCL指数)已被报道为前交叉韧带(ACL)重建的诊断和预后标志物。PCL指数对自体腘绳肌腱重建ACL的临床相关性在文献中尚未描述。本研究的目的是评估PCL指数作为解剖重建标志物以及接受自体腘绳肌腱ACL重建患者功能改善标志物的重要性。24例患者接受了自体腘绳肌腱ACL重建。术前和术后通过磁共振成像评估PCL指数。通过国际膝关节文献委员会(IKDC)主观膝关节评估表©和膝关节协会膝关节评分系统©(IKS)进行功能评估。患者的PCL指数、IKDC和IKS评分呈现出显著的正向变化。PCL指数变化与IKDC和IKS评分之间无显著相关性(p>0.05)。与其他报道PCL指数、旋转运动控制以及接受自体骨-髌腱-骨ACL重建患者功能改善之间关系的研究不同,本研究未证实这种关联。本研究有证据表明,PCL指数可作为ACL的解剖重建标志物,但不能预测此类重建的临床结果。

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Anterior cruciate ligament reconstruction: principles of treatment.前交叉韧带重建:治疗原则
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A meta-analysis of bone-patellar tendon-bone autograft versus four-strand hamstring tendon autograft for anterior cruciate ligament reconstruction.髌腱骨自体移植与四股绳肌肌腱自体移植用于前交叉韧带重建的荟萃分析。
Knee. 2015 Mar;22(2):100-10. doi: 10.1016/j.knee.2014.11.014. Epub 2014 Dec 11.
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The PCL index is correlated with the control of rotational kinematics that is achieved after anatomic anterior cruciate ligament reconstruction.PCL 指数与解剖前交叉韧带重建后实现的旋转运动学控制相关。
Am J Sports Med. 2014 Mar;42(3):665-74. doi: 10.1177/0363546513512780. Epub 2013 Dec 11.
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A two- and five-year follow-up of clinical outcome after ACL reconstruction using BPTB or hamstring tendon grafts: a prospective intervention outcome study.使用双束半腱肌肌腱或腘绳肌腱移植进行前交叉韧带重建术后临床结果的两年和五年随访:一项前瞻性干预结果研究。
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