Held Michael, Laubscher Martiz, von Bormann Richard, Richter Dustin L, Wascher Daniel C, Schenck Robert C
Department of Orthopaedic Surgery, Groote Schuur Hospital, Orthopaedic Research Unit, University of Cape Town, 7925 Cape Town, South Africa.
Knee Unit, Groote Schuur Hospital and Christiaan Barnard Memorial Hospital, University of Cape Town, 7700 Cape Town, South Africa.
SICOT J. 2021;7:17. doi: 10.1051/sicotj/2021016. Epub 2021 Mar 22.
Arthroscopic surgery is the gold standard for cruciate ligament reconstruction in multi-ligament knee injuries. However, hospitals in limited-resource settings often lack arthroscopic-trained surgeons or equipment. Open approaches for treating knee dislocations can overcome many of these limitations.
This study aims to describe techniques for open approaches in a supine patient to address the cruciate ligaments in multi-ligament knee injuries and to review associated complications and clinical outcomes in a retrospective case series.
Ten patients with multi-ligament knee injuries who had undergone open cruciate ligament reconstruction between July 2016 and November 2018 were retrospectively identified. Open approaches were performed owing to the extravasation of arthroscopy fluid into the posterior compartment (3) or a large traumatic arthrotomy (7). Complications and patient-reported outcomes were analysed. Eight of the 10 patients were followed up at 10 months postoperatively (range, 5-23 months). None had iatrogenic neurovascular damage. Median outcomes scores were: visual analogue scale, 45 (range, 0-100); Knee Injury and Osteoarthritis Outcome Score-Physical Function Short Form, 81.4 (range, 75-100); Lysholm, 85 (range, 67-92).
Open approaches were safe and useful in treating cruciate ligaments and should be considered in arthroscopy fluid extraversion and large traumatic arthrotomies.
关节镜手术是多韧带膝关节损伤中交叉韧带重建的金标准。然而，资源有限地区的医院往往缺乏经过关节镜培训的外科医生或设备。开放手术治疗膝关节脱位可克服其中许多限制。
本研究旨在描述仰卧位患者开放手术治疗多韧带膝关节损伤中交叉韧带的技术，并回顾一个回顾性病例系列中的相关并发症及临床结果。
回顾性确定了2016年7月至2018年11月期间接受开放交叉韧带重建的10例多韧带膝关节损伤患者。进行开放手术的原因是关节镜液体渗入后关节腔（3例）或大面积创伤性关节切开术（7例）。分析了并发症及患者报告的结果。10例患者中有8例在术后10个月（范围5 - 23个月）进行了随访。均未发生医源性神经血管损伤。结果评分中位数为：视觉模拟量表，45分（范围0 - 100分）；膝关节损伤和骨关节炎结果评分 - 身体功能简表，81.4分（范围75 - 100分）；Lysholm评分，85分（范围67 - 92分）。
开放手术在治疗交叉韧带方面安全且有用，在关节镜液体外渗和大面积创伤性关节切开术的情况下应予以考虑。
