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膝关节多韧带损伤一期重建的短期至中期疗效

Short to Mid-term Outcomes of Single-stage Reconstruction of Multiligament Knee Injury.

作者信息

Bagherifard Abolfazl, Jabalameli Mahmoud, Ghaffari Salman, Rezazadeh Jafar, Abedi Majid, Mirkazemi Masoud, Aghamohamadi Javad, Hesabi Afshin, Mohammadpour Mehdi

机构信息

Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran.

Research performed at Shafa Orthopedic Hospital, Tehran, Iran.

出版信息

Arch Bone Jt Surg. 2019 Jul;7(4):346-353.

Abstract

BACKGROUND

Multiligament knee injury (MLKI) is a complex orthopedic injury leading to the tear of at least two of the major knee ligaments. However, there is no consensus on the optimal management of this debilitating condition. Regarding this, the present study was performed to evaluate the outcomes of single-stage multiligament reconstruction surgery in patients with MLKI.

METHODS

This retrospective study was conducted on 41 consecutive MLKI patients who underwent surgical reconstruction. Objective evaluation of the outcome included active extension and flexion. Furthermore, the subjective evaluation of the outcome was accomplished using the Lysholm scoring scale and International Knee Documentation Committee (IKDC) form in Persian. Postoperative complications were also recorded for all patients.

RESULTS

The mean age of the participants was 31.95±7.82 years. In addition, the mean follow-up period and the mean time interval between the injury and surgery were recorded as 36.9±17.8 and 11.5±8.9 months, respectively. The mean Lysholm and IKDC scores were obtained as 86.9±11.5 and 70±18.7, respectively. The mean Lysholm and IKDC scores were not statistically different between the patients who underwent surgery less than 6 months after the injury and those subjected to reconstruction 6 months postinjury ( and , respectively). Seven patients showed postoperative restricted range of motion, which was resolved with physiotherapy. The only surgical complication was popliteal artery injury.

CONCLUSION

As the findings indicated, the single-stage reconstruction of MLKI provided an acceptable outcome. However, several aspects of this reconstruction, such as the timing of the surgery, still remain to be resolved in future investigations.

摘要

背景

膝关节多韧带损伤(MLKI)是一种复杂的骨科损伤,会导致至少两条主要膝关节韧带撕裂。然而,对于这种使人衰弱的病症的最佳治疗方法尚无共识。关于这一点,本研究旨在评估MLKI患者单阶段多韧带重建手术的效果。

方法

本回顾性研究对41例连续接受手术重建的MLKI患者进行。对结果的客观评估包括主动伸展和屈曲。此外,使用Lysholm评分量表和波斯语的国际膝关节文献委员会(IKDC)表格对结果进行主观评估。还记录了所有患者的术后并发症。

结果

参与者的平均年龄为31.95±7.82岁。此外,平均随访期以及损伤与手术之间的平均时间间隔分别记录为36.9±17.8个月和11.5±8.9个月。平均Lysholm和IKDC评分分别为86.9±11.5和70±18.7。受伤后不到6个月接受手术的患者与受伤后6个月接受重建的患者之间,平均Lysholm和IKDC评分在统计学上没有差异(分别为 和 )。7例患者术后出现活动范围受限,通过物理治疗得以解决。唯一手术并发症是腘动脉损伤。

结论

如研究结果所示,MLKI的单阶段重建提供了可接受的结果。然而,这种重建的几个方面,如手术时机,仍有待未来研究解决。

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