Department for Orthopedic Sports Medicine, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.
Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Westfalian-Wilhelms University Muenster, Muenster, Germany.
Knee Surg Sports Traumatol Arthrosc. 2021 Nov;29(11):3846-3853. doi: 10.1007/s00167-020-06409-3. Epub 2021 Jan 23.
To compare post-operative physical activity and return to work after combined posterolateral corner (PLC) reconstruction (PLC-R) in anterior cruciate ligament (ACL)- or posterior cruciate ligament (PCL)-based injuries.
Patients aged > 18 years undergoing PLC-R using the Larson technique combined with either ACL or PCL reconstruction were included. Outcome was evaluated retrospectively after a minimum follow-up of 24 months using Tegner Activity Scale, Activity Rating Scale (ARS), Knee Injury and Osteoarthritis Outcome Score (KOOS), work intensity according to REFA classification, and a questionnaire about type of occupation and time to return to work.
A total of 32 patients (11 ACL-based injuries and 21 PCL-based injuries) were included. Mean follow-up was 56 ± 26 months in the ACL-based injury group and 59 ± 24 months in the PCL-based injury group. All patients in the ACL-based injury group and 91% of patients in the PCL-based injury group returned to sports activities. Comparing pre- and post-operative values, a significant deterioration of the Tegner Activity Scale and ARS was observed in the PCL-based injury group, whereas no significant change was observed in the ACL-based injury group. KOOS subscales were generally higher in the ACL-based injury with significant differences in the subscale sports and recreational activities. Patients with ACL-based injuries returned to work significantly earlier compared to patients with PCL-based injuries (11 ± 4 weeks vs. 21 ± 10 weeks, p < 0.05).
High rates of return to sports and work can be expected after combined PLC-R in both ACL- and PCL-based injuries. However, deterioration of sports ability must be expected in PCL-based injuries. ACL-based injuries led to superior patient-reported outcomes and an earlier return to work, as compared to PCL-based injuries.
Level IV.
比较前交叉韧带（ACL）或后交叉韧带（PCL）损伤基础上联合后外侧角（PLC）重建（PLC-R）后的术后体力活动和重返工作情况。
纳入年龄>18 岁、接受 Larson 技术联合 ACL 或 PCL 重建的 PLC-R 患者。采用 Tegner 活动量表、活动评分量表（ARS）、膝关节损伤和骨关节炎结果评分（KOOS）、根据 REFA 分类的工作强度以及关于职业类型和重返工作时间的问卷，对至少 24 个月的随访结果进行回顾性评估。
共纳入 32 例患者（11 例 ACL 损伤，21 例 PCL 损伤）。ACL 损伤组平均随访 56±26 个月，PCL 损伤组平均随访 59±24 个月。ACL 损伤组所有患者和 PCL 损伤组 91%的患者均重返运动活动。与术前相比，PCL 损伤组的 Tegner 活动量表和 ARS 显著恶化，而 ACL 损伤组无显著变化。ACL 损伤组的 KOOS 亚量表普遍较高，其中运动和娱乐活动亚量表差异有统计学意义。与 PCL 损伤组相比，ACL 损伤组患者重返工作的时间明显更早（11±4 周比 21±10 周，p<0.05）。
在 ACL 和 PCL 损伤基础上联合 PLC-R 后，患者有很高的几率能够重返运动和工作。然而，PCL 损伤后运动能力可能会恶化。与 PCL 损伤相比，ACL 损伤的患者报告结果更好，重返工作的时间更早。
IV 级。
