He Qingsong, Liang Qingwei, Zhang Hangzhou
Department of Orthopaedics, the First Affiliated Hospital of China Medical University, Shenyang Liaoning, 110001, P.R.China.
Department of Orthopaedics, the First Affiliated Hospital of China Medical University, Shenyang Liaoning, 110001,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2019 May 15;33(5):551-554. doi: 10.7507/1002-1892.201810012.
To investigate effect of posterior oblique ligament (POL) repair on the rotational stability of the knee joint for the medial collateral ligament (MCL) combined with anterior cruciate ligament (ACL) ruptures.
The clinical data of 50 patients (50 knees) with grade-3 MCL-ACL combined injuries who met the selection criteria between January 2013 and December 2015 were retrospectively analyzed. All ACLs were reconstructed with autogenous tendon and the superficial and deep layers of MCLs were sutured; then, POLs were also sutured in 25 patients of repair group and only received conservation treatment postoperatively in 25 patients of conservation group. There was no significant difference in gender, age, disease duration, and preoperative KT-1000 measuring, medial joint space opening, International Knee Documentation Committee (IKDC) score, visual analogue scale (VAS) score, and knee range of motion between the two groups ( >0.05).
All incisions of the two groups healed by first intention, no surgical related complications occurred. All patients were followed up, with follow-up time of 28-56 months (mean, 38.1 months) in repair group and 26-55 months (mean, 29.1 months) in conservation group. At last follow-up, the IKDC score, VAS score, KT-1000 measuring, medial joint space opening, and knee range of motion significantly improved in the two groups when compared with preoperative ones ( <0.05); but there was no significant difference between the two groups ( >0.05). The Slocum test showed that there was no instability of the anterior medial rotation in the two groups.
The POL repair can't obtain more medial stability after ACL reconstruction and MCL repair (superficial and deep layers) for patients who have MCL-ACL combined injuries.
探讨后斜韧带(POL)修复对内侧副韧带(MCL)合并前交叉韧带(ACL)断裂膝关节旋转稳定性的影响。
回顾性分析2013年1月至2015年12月间符合入选标准的50例(50膝)3级MCL-ACL联合损伤患者的临床资料。所有ACL均采用自体肌腱重建,MCL的浅层和深层均进行缝合;然后,修复组25例患者还缝合了POL,而保守组25例患者术后仅接受保守治疗。两组在性别、年龄、病程、术前KT-1000测量、内侧关节间隙开口、国际膝关节文献委员会(IKDC)评分、视觉模拟量表(VAS)评分和膝关节活动范围方面差异均无统计学意义(>0.05)。
两组所有切口均一期愈合,未发生手术相关并发症。所有患者均获随访,修复组随访时间为28 - 56个月(平均38.1个月),保守组为26 - 55个月(平均29.1个月)。末次随访时,两组IKDC评分、VAS评分、KT-1000测量、内侧关节间隙开口和膝关节活动范围与术前相比均显著改善(<0.05);但两组间差异无统计学意义(>0.05)。Slocum试验显示两组均无前内侧旋转不稳定。
对于MCL-ACL联合损伤患者,在ACL重建和MCL修复(浅层和深层)后,POL修复不能获得更多的内侧稳定性。