Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.
Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China.
J Orthop Surg Res. 2020 Jul 31;15(1):295. doi: 10.1186/s13018-020-01810-7.
Posterior cruciate ligament (PCL) avulsion fracture of the tibia is an uncommon but serious complication during primary cruciate-retaining total knee arthroplasty (TKA). The first objective of this report was to conduct a retrospective cohort study to investigate the incidence and potential risk factors of PCL avulsion fracture in primary cruciate-retaining TKA. The second objective was to assess the functional outcomes of the knee after reduction of PCL avulsion fracture.
From January 2014 to January 2016, 56 patients who experienced PCL avulsion fracture of the tibia in primary cruciate-retaining TKA were included in the study group. Patients in this group underwent reduction of avulsion fracture. In this period, we selected 224 patients (control group) for comparison. Patients in this group also underwent the same TKA, but no PCL avulsion fracture occurred. The range of motion of the knee and Knee Society Scores were assessed. The Forgotten Joint Score was used to analyze the ability to forget the joint. Differences were considered statistically significant at p < 0.05.
In our series, the incidence of PCL avulsion fracture was 4.6%. There were no significant differences (p > 0.05) with regard to the preoperative or postoperative range of motion of the knee, final 4-year mean clinical score in the study and control groups 92.4 ± 2.7 and 93.6 ± 1.9, respectively, and mean functional scores of 85.1 ± 1.8 and 87.1 ± 1.2, respectively.
The incidence of PCL avulsion fracture of the tibia is relatively high. Older age and female gender were the two risk factors of fracture in primary cruciate-retaining TKA. Reduction of PCL avulsion fracture with a high-strength line can achieve good stability and function of the knee.
后交叉韧带（PCL）胫骨撕脱骨折是初次保留交叉韧带的全膝关节置换术（TKA）中一种罕见但严重的并发症。本报告的首要目的是进行回顾性队列研究，以调查初次保留交叉韧带的 TKA 中 PCL 撕脱骨折的发生率和潜在危险因素。第二个目的是评估 PCL 撕脱骨折复位后的膝关节功能结果。
从 2014 年 1 月至 2016 年 1 月，56 例初次保留交叉韧带的 TKA 中发生胫骨 PCL 撕脱骨折的患者被纳入研究组。该组患者接受了撕脱骨折复位。在这一时期，我们选择了 224 例（对照组）患者进行比较。该组患者也接受了相同的 TKA，但未发生 PCL 撕脱骨折。评估了膝关节的活动范围和膝关节协会评分。采用遗忘关节评分分析关节遗忘能力。差异具有统计学意义（p < 0.05）。
在我们的系列中，PCL 撕脱骨折的发生率为 4.6%。两组患者术前和术后膝关节活动度、研究组和对照组的最终 4 年平均临床评分分别为 92.4 ± 2.7 和 93.6 ± 1.9，以及平均功能评分分别为 85.1 ± 1.8 和 87.1 ± 1.2，差异均无统计学意义（p > 0.05）。
胫骨 PCL 撕脱骨折的发生率相对较高。年龄较大和女性是初次保留交叉韧带的 TKA 骨折的两个危险因素。高强度线复位 PCL 撕脱骨折可获得膝关节良好的稳定性和功能。
