The Second Affiliated Hospital of Anhui Medical University, Hefei, China, China.
Center for Clinical Medicine, Huatuo Institute of Medical Innovation (HTIMI), Berlin, Germany.
PeerJ. 2022 Jul 14;10:e13732. doi: 10.7717/peerj.13732. eCollection 2022.
To evaluate the clinical efficacy of a minimally invasive arthroscopic approach and to compare it with the traditional inverted "L" approach for the treatment of posterior cruciate ligament (PCL) avulsion fractures.
From January 2016 to January 2020, the clinical data from patients with PCL avulsion fracture of the tibial insertion were analyzed retrospectively. They were divided into two groups based on surgical approaches: minimally invasive approach group ( = 15) and traditional inverted "L" group ( = 15 cases). The operation time, incision length, intraoperative blood loss, hospitalization time and complications were all recorded and compared between the two groups. The fracture healing time, knee range of motion (ROM), and residual relaxation degree were compared between the two groups after regular follow-up. The International Knee Documentation Committee (IKDC) and Lysholm scores were used to assess knee joint function.
There were no significant differences between the two groups in terms of gender, age, side, body mass index, cause of injury, Meyers McKeever classification and time from injury to operation ( > 0.05). The incision length and intraoperative bleeding in the minimally invasive group were significantly lower ( < 0.05) than those in the traditional group. There were no significant differences between the two groups in terms of operative time, fracture healing time, or residual relaxation ( > 0.05). The Lachman test and posterior drawer test were both negative, and there were no postoperative complications. The VAS pain score within 2 weeks and ROM within 4 weeks in the minimally invasive group were significantly better ( < 0.05) than those in the traditional inverted "L" approach group. The knee joint stability of both groups was good 12 months after surgery, and there were no significant differences in IKDC score, Lysholm score and ROM ( > 0.05) between the two groups.
The minimally invasive approaches for the treatment of PCL avulsion fractures provide adequate exposure without the surgical complications associated with traditional open surgical approaches. The procedure is safe, fast and minimally invasive, and does not need a long learning curve.
评估微创关节镜入路治疗后交叉韧带（PCL）胫骨止点撕脱骨折的临床疗效，并与传统的倒"L"入路进行比较。
回顾性分析 2016 年 1 月至 2020 年 1 月收治的 PCL 胫骨止点撕脱骨折患者的临床资料，根据手术入路分为微创组（微创组）和传统倒"L"组（传统组），每组 15 例。记录并比较两组患者的手术时间、切口长度、术中出血量、住院时间和并发症。定期随访比较两组患者骨折愈合时间、膝关节活动度（ROM）和残余松弛度。采用国际膝关节文献委员会（IKDC）和 Lysholm 评分评估膝关节功能。
两组患者性别、年龄、侧别、体质量指数、致伤原因、Meyers-McKeever 分型及伤后至手术时间比较，差异均无统计学意义（>0.05）。微创组切口长度和术中出血量明显低于传统组（<0.05）。两组手术时间、骨折愈合时间和残余松弛度比较，差异均无统计学意义（>0.05）。两组患者 Lachman 试验和后抽屉试验均为阴性，均无术后并发症。微创组术后 2 周 VAS 疼痛评分和术后 4 周 ROM 明显优于传统组（<0.05）。两组患者术后 12 个月膝关节稳定性良好，IKDC 评分、Lysholm 评分和 ROM 比较，差异均无统计学意义（>0.05）。
微创治疗 PCL 胫骨止点撕脱骨折可提供充分暴露，避免传统开放式手术相关的手术并发症。该术式安全、快速、微创，且无需较长的学习曲线。
