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关节镜下单束与双束后交叉韧带重建的临床疗效:一项回顾性研究。

Clinical efficacy of arthroscopic single-bundle versus double-bundle reconstruction of the posterior cruciate ligament: a retrospective study.

作者信息

Chen Tian-Xin, Yu Mei-Qi, Dong Ting-Ting, Li Yan, Zhang Sheng, Zhang Lei

机构信息

Department of Sports Medicine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, 100102, China.

Beijing University of Chinese Medicine, Beijing, 100029, China.

出版信息

Int Orthop. 2025 Jan;49(1):93-100. doi: 10.1007/s00264-024-06360-9. Epub 2024 Nov 1.

Abstract

PURPOSE

To compare the functional and clinical outcomes of knee joints in patients over a 10-year period following posterior cruciate ligament (PCL) reconstruction with single-bundle versus double-bundle.

METHODS

Patients who underwent PCL reconstruction were retrospectively analyzed. Based on the surgical approach, they were divided into the single-bundle reconstruction group and the double-bundle reconstruction group. Preoperative and postoperative Lysholm score, International Knee Documentation Committee (IKCD) score, and Tegner activity score were evaluated, and the stability of the joints was assessed using KT-2000 arthrometer. Radiographs were taken at the final follow-up to evaluate the progression of osteoarthritis.

RESULTS

A total of 61 patients were included in the analysis: 26 in the double-bundle group and 35 in the single-bundle group. Baseline data were comparable between the two groups (P > 0.05). There were no significant differences between the two groups in preoperative Lysholm, IKDC score, and Tegner activity score. Postoperatively, these scores were significantly higher at two and ten years follow-up (P < 0.05), with no significant difference between the groups (P > 0.05). There was no significant difference in side-to-side differences (SSD) at 30° and 90° of knee flexion preoperatively between the groups (P > 0.05). Postoperatively, SSD decreased significantly at the two year and ten year follow-up (P < 0.05), with no significant difference between the groups (P > 0.05). For osteoarthritis progression, there were four cases of Kellgren-Lawrence grade ≥ II in the single-bundle group and three cases in the double-bundle group, with no significant difference in the progression of osteoarthritis between the groups (P > 0.05).

CONCLUSION

Both single-bundle and double-bundle reconstructions for PCL result in good joint stability and mobility, with similar progression of osteoarthritis in long-term follow-up.

LEVEL OF EVIDENCE

Level III.

摘要

目的

比较单束与双束后交叉韧带(PCL)重建术后10年以上患者膝关节的功能和临床结果。

方法

对接受PCL重建的患者进行回顾性分析。根据手术方式,将他们分为单束重建组和双束重建组。评估术前和术后的Lysholm评分、国际膝关节文献委员会(IKCD)评分和Tegner活动评分,并使用KT-2000关节测量仪评估关节稳定性。在最终随访时拍摄X线片以评估骨关节炎的进展。

结果

共有61例患者纳入分析:双束组26例,单束组35例。两组基线数据具有可比性(P>0.05)。两组术前Lysholm、IKDC评分和Tegner活动评分无显著差异。术后,在2年和10年随访时这些评分显著更高(P<0.05),组间无显著差异(P>0.05)。术前两组在膝关节屈曲30°和90°时的侧方差异(SSD)无显著差异(P>0.05)。术后,在2年和10年随访时SSD显著降低(P<0.05),组间无显著差异(P>0.05)。对于骨关节炎进展,单束组有4例Kellgren-Lawrence分级≥II级,双束组有3例,两组骨关节炎进展无显著差异(P>0.05)。

结论

PCL的单束和双束重建均能带来良好的关节稳定性和活动度,在长期随访中骨关节炎进展相似。

证据水平

III级。

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