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保留后交叉韧带的全膝关节置换术中后交叉韧带部分松解与非松解的长期疗效:至少 15 年随访结果。

Long-term Results of Partial Release Versus Nonrelease of the Posterior Cruciate Ligament at Cruciate-Retaining Total Knee Arthroplasty: Minimum 15-Year Follow-up.

出版信息

Orthopedics. 2022 Jul-Aug;45(4):233-238. doi: 10.3928/01477447-20220225-01. Epub 2022 Mar 4.

Abstract

The goal of this study was to compare the clinical and radiologic results of posterior cruciate ligament (PCL) partial release and PCL nonrelease in performing cruciate-retaining total knee arthroplasty (CR-TKA) for a long-term follow-up period of greater than 15 years. A total of 224 patients underwent CR-TKA in our hospital from June 1996 to April 2002 with greater than 15 years of follow-up. We divided the subjects into 2 groups based on release of the PCL. Group 1 was the PCL partial release group (88 cases), and group 2 was the PCL nonrelease group (136 cases). The mean follow-up period was 16.8 years (range, 15.5-19.5 years). We compared the clinical results by measuring the Knee Society Score (KSS), Hospital for Special Surgery (HSS) score, and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score preoperatively and at the last follow-up. For radiologic results, the Knee Society Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System was used and stress radiographs were obtained at the last follow-up to evaluate PCL function. There was no statistically meaningful difference in radiologic and clinical results between the 2 groups. Radiolucent lines were found for 13 patients radiologically (6 in group 1 and 7 in group 2). No instability as a result of PCL insufficiency required revision surgery on stress radiography at the last follow-up. If an appropriate procedure is performed according to PCL function intraoperatively, CR-TKA can produce a satisfactory result on long-term follow-up. [. 2022;45(4):233-238.].

摘要

本研究旨在比较后交叉韧带(PCL)部分松解和不松解在进行保留后交叉韧带的全膝关节置换术(CR-TKA)中的临床和影像学结果,随访时间超过 15 年。共有 224 例患者于 1996 年 6 月至 2002 年 4 月在我院接受 CR-TKA 治疗,随访时间超过 15 年。我们根据 PCL 的释放情况将患者分为 2 组。第 1 组为 PCL 部分松解组(88 例),第 2 组为 PCL 不松解组(136 例)。平均随访时间为 16.8 年(范围:15.5-19.5 年)。我们通过测量膝关节协会评分(KSS)、特殊外科医院(HSS)评分和西安大略和麦克马斯特大学骨关节炎(WOMAC)评分来比较术前和末次随访时的临床结果。影像学结果采用膝关节协会全膝关节置换术 X 线评估和评分系统,并在末次随访时获得应力 X 线片来评估 PCL 功能。2 组的影像学和临床结果无统计学差异。影像学上发现 13 例患者存在透亮线(1 组 6 例,2 组 7 例)。末次随访时,在应力 X 线片上未发现因 PCL 不足引起的不稳定需要翻修手术。如果在术中根据 PCL 功能进行适当的手术,CR-TKA 可以在长期随访中获得满意的结果。[Orthop Traumatol Surg Res. 2022;45(4):233-238.]。

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