Holuba Kurt, Rilk Sebastian, Vermeijden Harmen D, O'Brien Robert, van der List Jelle P, DiFelice Gregory S
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A.
Medical University of Vienna, Vienna, Austria.
Arthrosc Sports Med Rehabil. 2023 Oct 4;5(6):100799. doi: 10.1016/j.asmr.2023.100799. eCollection 2023 Dec.
To assess the clinical and patient-reported outcome measures (PROMs) of acute superficial medial collateral ligament (sMCL) repair with suture augmentation (SA) in the setting of a multiligamentous injured knees (MLIKs) at 2-year follow-up.
A retrospective analysis of consecutive patients with MLIK with grade III sMCL injuries who underwent acute (<6 weeks) sMCL repair with SA was conducted. Clinical follow-up was performed at minimum 1-year postoperatively, and PROMs were collected at the latest follow-up (minimum 2 years' postoperatively). Continuous variables were reported in median with interquartile range (IQR).
A total of 20 patients (41.4 [28.5-47.9] years of age) with grade III sMCL injury and additional injury to 1 cruciate ligament (KDI-M; n = 13) or bicruciate (KDIII-M; n = 7) were enrolled with a median follow-up of 4.3 (3.6-5.2) years. In total, 90% (n = 18) of patients with MLIK treated with acute sMCL repair and early range of motion rehabilitation protocol demonstrated negative valgus laxity stress testing in 0 and 30° flexion and low reoperation rates (n = 1, 5%) due to stiffness. In addition, good-to-excellent subjective outcomes were reported at final follow-up: median International Knee Documentation Committee 82.2 (78.7-90.8), Lysholm 95.0 (90.0-100.0), modified Cincinnati Score 89.0 (83.3-96.0), Single Assessment Numeric Evaluation 90.0 (83.8-95.0), Forgotten Joint Score 79.2 (62.5-91.7), Tegner 5.0 (IQR 4.0-6.0), and ACL-Return to Sport after Injury Scale 78.3 (IQR 66.7-90.0).
In this study, 20 heterogenous patients with MLIKs treated with acute percutaneous sMCL repair with SA had excellent stability, low rates of postoperative stiffness, and good-to-excellent PROMs at short-term follow-up.
Level IV, therapeutic case series.
评估在多韧带损伤膝关节（MLIKs）中，采用缝线增强（SA）技术进行急性浅表内侧副韧带（sMCL）修复术后2年的临床及患者报告结局指标（PROMs）。
对连续的MLIK且sMCL损伤为III级并接受急性（<6周）SA技术sMCL修复的患者进行回顾性分析。术后至少1年进行临床随访，并在最近一次随访（术后至少2年）时收集PROMs。连续变量以中位数及四分位数间距（IQR）报告。
共纳入20例患者（年龄41.4 [28.5 - 47.9]岁），其sMCL损伤为III级，且合并1条交叉韧带损伤（KDI - M；n = 13）或双交叉韧带损伤（KDIII - M；n = 7），中位随访时间为4.3（3.6 - 5.2）年。总体而言，90%（n = 18）接受急性sMCL修复及早期活动范围康复方案治疗的MLIK患者在0°和30°屈曲时外翻松弛应力试验为阴性，且因僵硬导致的再次手术率较低（n = 1，5%）。此外，末次随访时报告的主观结局良好至优秀：国际膝关节文献委员会评分中位数82.2（78.7 - 90.8），Lysholm评分95.0（90.0 - 100.0），改良辛辛那提评分89.0（83.3 - 96.0），单评估数字评价90.0（83.8 - 95.0），遗忘关节评分79.2（62.5 - 91.7），Tegner评分5.0（IQR 4.0 - 6.0），以及前交叉韧带损伤后恢复运动量表评分78.3（IQR 66.7 - 90.0）。
在本研究中，20例采用急性经皮SA技术sMCL修复治疗的异质性MLIK患者在短期随访时具有出色的稳定性、较低的术后僵硬发生率及良好至优秀的PROMs。
IV级，治疗性病例系列。
