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。