Zhong Hehe, Jin Ying, Wu Shuhong, Liu Yi
Department of Joint Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi Guizhou, 563003, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Feb 15;35(2):166-170. doi: 10.7507/1002-1892.202008051.
To discuss the effectiveness of posterior cruciate ligament (PCL) reconstruction with autologous peroneus longus tendon under arthroscopy.
Between January 2016 and December 2018, 46 patients with PCL injuries were enrolled. There were 34 males and 12 females, with an average age of 40.7 years (range, 20-58 years). There were 43 cases of acute injury and 3 cases of old injury. The anterior drawer test and the posterior tibia sign were positive in 4 cases, the posterior drawer tests and the posterior tibia sign were positive in 46 cases, the varus stress tests were positive in 10 cases, and the valgus stress tests were positive in 6 cases. The difference of dial-test at 30° knee flexion between affected and healthy sides was (5.20±3.91)°. The tibia posterior displacement under posterior stress position was (12.03±2.38) mm. The Lysholm score of the knee joint was 36.68±7.89, the International Knee Documentation Committee (IKDC) score was 33.58±5.97, and the American Orthopaedic Foot and Ankle Association (AOFAS) score of the ankle joint was 97.60±1.85. PCL was reconstructed with autologous peroneus longus tendon under arthroscopy, and the combined meniscus injury, posterolateral complex injury, and anterior cruciate ligament injury were all treated according to the degree of injury.
All incisions healed by first intention. Forty patients were followed up 12-26 months, with an average of 16.0 months. At last follow-up, the Lysholm score of the knee joint was 84.85±7.03, and the IKDC score was 87.13±6.27, which were significant different from preoperative ones ( =-13.45, =0.00; = -39.12, =0.00); the AOFAS score of ankle joint was 93.98±2.14, which was not significant different from preoperative one ( =8.09, =0.90). The tibia posterior displacement under posterior stress position was (2.75±1.76) mm and the difference of dial-test at 30° knee flexion between affected and healthy sides was (1.75±2.09)°, which were significant different from preoperative ones ( =29.00, =0.00; =4.96, =0.00). The posterior drawer test and the posterior tibia sign were positive in 1 case and negative in 39 cases; the anterior drawer test and the varus and valgus stress tests were all negative.
Reconstruction of PCL with autologous peroneus longus tendon under arthroscopy can significantly improve the stability and function of the knee joint, with satisfactory clinical results.
探讨关节镜下自体腓骨长肌腱重建后交叉韧带（PCL）的疗效。
选取2016年1月至2018年12月间46例PCL损伤患者。其中男性34例，女性12例，平均年龄40.7岁（范围20 - 58岁）。急性损伤43例，陈旧性损伤3例。前抽屉试验及后胫骨征阳性4例，后抽屉试验及后胫骨征阳性46例，内翻应力试验阳性10例，外翻应力试验阳性6例。患侧与健侧膝关节屈曲30°时旋转试验差值为（5.20±3.91）°。后应力位胫骨后移（12.03±2.38）mm。膝关节Lysholm评分为36.68±7.89，国际膝关节文献委员会（IKDC）评分为33.58±5.97，踝关节美国矫形足踝协会（AOFAS）评分为97.60±1.85。关节镜下采用自体腓骨长肌腱重建PCL，合并的半月板损伤、后外侧复合体损伤及前交叉韧带损伤均根据损伤程度进行处理。
所有切口均一期愈合。40例患者获12 - 26个月随访，平均16.0个月。末次随访时，膝关节Lysholm评分为84.85±7.03，IKDC评分为87.13±6.27，与术前比较差异有统计学意义（=-13.45，=0.00；=-39.12，=0.00）；踝关节AOFAS评分为93.98±2.14，与术前比较差异无统计学意义（=8.09，=0.90）。后应力位胫骨后移（2.75±1.76）mm，患侧与健侧膝关节屈曲30°时旋转试验差值为（1.75±2.09）°，与术前比较差异有统计学意义（=29.00，=0.00；=4.96，=0.00）。后抽屉试验及后胫骨征阳性1例，阴性39例；前抽屉试验及内翻、外翻应力试验均为阴性。
关节镜下自体腓骨长肌腱重建PCL可显著提高膝关节稳定性及功能，临床效果满意。
