Jin Cheng, Song Eun-Kyoo, Jin Quan-He, Seon Jong-Keun, Sun Si-Mei
Zhoushan Hospital, Zhejiang University School of Medicine, Zhoushan, China.
Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea.
Evid Based Complement Alternat Med. 2022 Jul 21;2022:7266233. doi: 10.1155/2022/7266233. eCollection 2022.
Complete detachment of the medial collateral ligament (MCL) may occur during medial release of total knee arthroplasty (TKA) in patients with severe varus knee osteoarthritis. This study was to determine functional and stability outcomes of repaired knee with complete detachment of MCL compared to those of contralateral nondetached MCL in patients with bilateral TKA.
Records of 1052 consecutive knees undergoing bilateral TKA from 2003 to 2015 were retrospectively reviewed. Of which, 45 patients were repaired for complete MCL detachment injury (2.1%) at tibial insertion in one side (repaired group). MCL was not detached in the contralateral side (control group). Clinical evaluation was performed preoperatively and at the final follow-up using KS and WOMAC scores between two groups. Similarly, stability was compared on a valgus stress radiograph between two groups.
Two patients had insufficient data. Hence, 43 patients were included after a minimum of 5 years follow-up. There were no significant differences in terms of alignment and clinical outcomes between the two groups either preoperatively or at the final follow-up ( > 0.05). Radiographic stability also showed no differences between repaired and control groups in extension and 30° of flexion (=0.208 and =0.125).
For tibial detachment of the MCL during TKA, repair with suture anchor provided good clinical and stability results, similar to TKA without MCL injury. Therefore, repair with a suture anchor is a reliable method that provides good clinical and stability outcomes in patients with MCL injury during TKA.
在严重膝内翻骨关节炎患者的全膝关节置换术（TKA）内侧松解过程中，内侧副韧带（MCL）可能会完全断裂。本研究旨在确定双侧TKA患者中，MCL完全断裂后修复的膝关节与对侧未断裂MCL的膝关节在功能和稳定性方面的结果。
回顾性分析2003年至2015年连续1052例接受双侧TKA患者的记录。其中，45例患者一侧胫骨附着处的MCL完全断裂接受修复（修复组）。对侧MCL未断裂（对照组）。术前及末次随访时采用KS和WOMAC评分对两组进行临床评估。同样，在两组之间的外翻应力X线片上比较稳定性。
2例患者数据不足。因此，43例患者在至少5年的随访后纳入研究。两组术前及末次随访时在对线和临床结果方面均无显著差异（>0.05）。影像学稳定性在修复组和对照组的伸直位及屈膝30°时也无差异（=0.208和=0.125）。
对于TKA术中MCL胫骨附着处断裂，使用缝线锚钉修复可提供良好的临床和稳定性结果，与未发生MCL损伤的TKA相似。因此，缝线锚钉修复是一种可靠的方法，可为TKA术中MCL损伤患者提供良好的临床和稳定性结果。
