Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, No374, Dianmian road, Kunming, 650101, China.
Department of Orthopaedics, The People's Hospital of WeiXin County, Zhaotong, China.
BMC Musculoskelet Disord. 2020 Jul 9;21(1):450. doi: 10.1186/s12891-020-03470-4.
Multiple knee ligament injuries combined with extensor apparatus rupture are serious and complex knee injuries that are rare in clinical practice. The management is extremely challenging and controversial. The aim of this study is to describe a patient collective with multiple knee ligament injuries combined with extensor apparatus injuries in detail and to report the mid-term outcomes of a one-stage surgical treatment regarding subjective outcome scores, complications, knee instability, and ROM.
Eleven of 425 patients with multiple knee ligament injuries combined with extensor apparatus injuries admitted to our hospital were reviewed from July 2008 to May 2017. All patients underwent one-stage repair and reconstruction of multiple knee ligaments and extensor apparatus. The Lysholm knee score and the International Knee Documentation Committee (IKDC) score were adopted to evaluate the surgical effect preoperatively and at a minimum of 2 years' follow-up. Clinical data, including range of motion and knee stability, were also recorded at the final follow-up.
Ten patients were followed up with a mean time of 40 (range, 24-60) months. At the last follow-up, 8 patients had joint flexion range of motion greater than or equal to120 degrees, 2 patients had joint flexion range of motion of 100-120 degrees, and 1 patient had active knee extension limitation of 5 degrees. Stress radiographs showed that the mean differences in posterior displacement were reduced from 10.8 ± 3.0 mm preoperatively to 2.0 ± 2.5 mm at the last follow-up. There were significant improvements in stress radiographs from pre- to postoperative states for all patients with multiple knee ligament injuries. The Lysholm score ranged from 85 to 96, with a mean of 92.1 (compared with 33 before surgery, P < 0.05). The final IKDC scores were A in 2 patients (20%), B in 7 (70%), and C in 1 (10%). Nine of the 10 patients (90%) returned to their former activity level.
Multiple knee ligament injuries combined with extensor apparatus rupture are rare. Single-stage management of the repair and reconstruction of multiple knee ligaments and extensor apparatus with proper rehabilitation is an effective and reliable procedure to restore knee stability and function.
Level IV, therapeutic case series.
多发膝关节韧带损伤合并伸膝装置断裂是一种严重而复杂的膝关节损伤，在临床实践中较为少见。这种损伤的处理极具挑战性且存在争议。本研究的目的是详细描述一组多发膝关节韧带损伤合并伸膝装置损伤的患者，并报告一期手术治疗的中期结果，包括主观评分、并发症、膝关节不稳定和活动度。
2008 年 7 月至 2017 年 5 月，我们对我院收治的 425 例多发膝关节韧带损伤合并伸膝装置损伤患者中的 11 例进行了回顾性研究。所有患者均接受了一期修复和重建多发膝关节韧带和伸膝装置。采用 Lysholm 膝关节评分和国际膝关节文献委员会（IKDC）评分评估术前和至少 2 年随访时的手术效果。在末次随访时还记录了临床数据，包括活动度和膝关节稳定性。
10 例患者获得了平均 40（范围 24-60）个月的随访。末次随访时，8 例患者膝关节屈曲活动度大于或等于 120°，2 例患者膝关节屈曲活动度为 100-120°，1 例患者膝关节主动伸直受限 5°。应力位 X 线片显示，所有多发膝关节韧带损伤患者的后向移位平均差值从术前的 10.8±3.0mm 减少至末次随访时的 2.0±2.5mm。所有患者的应力位 X 线片均较术前有明显改善。Lysholm 评分范围为 85-96 分，平均 92.1 分（与术前的 33 分相比，P<0.05）。最终的 IKDC 评分为 A 级 2 例（20%），B 级 7 例（70%），C 级 1 例（10%）。10 例患者中有 9 例（90%）恢复到以前的活动水平。
多发膝关节韧带损伤合并伸膝装置断裂较为少见。一期修复和重建多发膝关节韧带和伸膝装置，并进行适当的康复治疗，是恢复膝关节稳定性和功能的有效可靠方法。
IV 级，治疗性病例系列研究。
