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多发伤膝关节急性后交叉韧带损伤内固定后的临床及磁共振成像结果良好。

Promising clinical and magnetic resonance imaging results after internal bracing of acute posterior cruciate ligament lesions in multiple injured knees.

机构信息

Department of Orthopaedic Sports Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.

Department of Trauma, Orthopaedic, Plastic and Hand Surgery, University Hospital of Augsburg, Augsburg, Germany.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2020 Aug;28(8):2543-2550. doi: 10.1007/s00167-020-05852-6. Epub 2020 Feb 12.

DOI:10.1007/s00167-020-05852-6
PMID:32047998
Abstract

PURPOSE

The purpose of this study was to evaluate the clinical and radiological outcomes of acute posterior cruciate ligament (PCL) lesions in multiple injured knees that were surgically treated with internal bracing.

METHODS

Acute complete PCL lesions in multiple injured knees with subsequent internal-bracing treatment within 21 days between 2014 and 2016 were eligible for inclusion. At final follow-up, patients were assessed with Tegner, Lysholm, and IKDC scores. PCL stability and healing were verified with KT-2000, stress radiography and magnetic resonance imaging (MRI).

RESULTS

Fourteen patients [mean age 37.4 (± 17.8; SD) years] were evaluated after a mean follow-up of 19.9 (± 7.7; SD) months. Thirteen patients suffered complete lesions of the PCL with concomitant ligamentous injuries (Schenck I: six cases, Schenck III M: five cases, Schenck IV N: one case, Schenck V: one case). Median Tegner, mean Lysholm and mean IKDC scores at follow-up were 4 (2-7; interquartile range), 69.1 (± 16.6; SD) and 68.9 (± 18.1; SD) respectively. Posterior translation averaged 5.8 (± 2.2; SD) mm with the KT 2000 and stress radiography showed a mean posterior tibial translation of 5.5 (± 4.1; SD) mm in the side to side comparison. MRI showed adequate PCL healing.

CONCLUSIONS

Internal bracing as treatment for acute PCL ruptures in multiple injured knees showed adequate restoration of posterior tibial translation in a single-centre study including 14 cases.

LEVEL OF EVIDENCE

IV.

摘要

目的

本研究旨在评估在 2014 年至 2016 年间,对 21 天内接受内固定支具治疗的多发伤膝关节急性后十字韧带(PCL)损伤的临床和影像学结果。

方法

本研究纳入了 2014 年至 2016 年间,接受内固定支具治疗的多发伤膝关节急性完全性 PCL 损伤患者。最终随访时,采用 Tegner、Lysholm 和 IKDC 评分评估患者。通过 KT-2000、应力位 X 线和磁共振成像(MRI)检查来验证 PCL 稳定性和愈合情况。

结果

14 例患者[平均年龄 37.4(±17.8;SD)岁]接受了平均 19.9(±7.7;SD)个月的随访。13 例患者 PCL 完全撕裂伴其他韧带损伤(Schenck I:6 例,Schenck III M:5 例,Schenck IV N:1 例,Schenck V:1 例)。随访时的中位数 Tegner 评分、平均 Lysholm 评分和平均 IKDC 评分为 4(2-7;四分位间距)、69.1(±16.6;SD)和 68.9(±18.1;SD)。KT-2000 检查显示平均后向胫骨平移 5.8(±2.2;SD)mm,侧位对比显示应力位 X 线检查平均后向胫骨平移 5.5(±4.1;SD)mm。MRI 显示 PCL 愈合良好。

结论

在包括 14 例患者的单中心研究中,内固定支具治疗多发伤膝关节急性 PCL 撕裂,可在后胫骨平移方面获得良好的恢复。

证据等级

IV。

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