Sundararajan Silvampatti Ramasamy, Ahmed Owais, Ramakanth Rajagopalakrishnan, Dsouza Terence, Irfan Mahshook, Palanisamy Arumugam, Rajasekaran Shanmuganathan
Department of Arthroscopy and Sports Medicine, Ganga Medical Center & Hospital, Coimbatore, India.
Department of Arthroscopy and Sports Medicine, Ganga Medical Center & Hospital, Coimbatore, India.
Knee. 2025 Mar;53:69-78. doi: 10.1016/j.knee.2024.11.017. Epub 2024 Dec 12.
To determine incidence of posterior-tibial-slope (PTS) distribution in patients with isolated posterior-cruciate-ligament (PCL) tear, as-well-as the effect of PTS on radiological, clinical, and functional outcomes after PCL-reconstruction (PCL-R).
63 patients with symptomatic isolated PCL-tears who underwent PCL-R were divided into two groups based on a PTS-angle with a cut-off value of 7-degrees: group-A (less than ≤7-degree) and group-B (more than >7-degree). All the patients were subjected to the same technique. The effect of PTS-angle on the radiological-outcome, (posterior-tibial-translation (PTT)) at 6-month and 1-year intervals was compared. Clinical-outcomes (knee range-of-motion (ROM), quadriceps-wasting (QW)), and functional outcomes (IKDC and Tegner-Lysholm scores) at 6-month, 1-year, and final follow-up was compared between the groups.
PTS of less than ≤7-degrees was seen in 66.7%. The mean-PTS-angle was 6.47 ± 2.40degrees. Radiologically, there was no statistical-difference in PTT at 6-months. However, at 1-year, PTT was less in group-A (3.98 ± 2.21 mm) than in group-B (3.03 ± 1.42 mm) (P = 0.04). Two patients in group-A had grade-III PTT at 6-months, and one of them had grade-III PTT at 1-year. At the mean-follow-up, group-A had lower IKDC and Tegner-Lysholm (81.55 ± 11.4, 90.19 ± 5.53) than group-B (86.56 ± 7.2, 94.6 ± 4.42), indicating a statistically significant difference (IKDC:P = 0.038, Tegner-Lysholm:P = 0.001). At 1-year and mean-follow-up, group-A had a significantly lower ROM(p = 0.047). There was no significant difference for QW at 6-months and 1-year.
Lesser preoperative PTS angle (≤7) has a negative effect on the outcome of isolated PCL-R and leads to secondaryposterior knee laxity than in patients with higher PTS angle (>7). Incidence of lesser posterior tibial slope (≤7) in isolated PCL injuries is 66.7%.
确定单纯后交叉韧带（PCL）损伤患者的胫骨后倾角（PTS）分布情况，以及PTS对PCL重建（PCL-R）术后影像学、临床和功能结局的影响。
63例有症状的单纯PCL损伤且接受PCL-R的患者，根据PTS角度以7度为界分为两组：A组（小于或等于≤7度）和B组（大于>7度）。所有患者均采用相同技术。比较PTS角度对6个月和1年时影像学结局（胫骨后移（PTT））的影响。比较两组在6个月、1年及最终随访时的临床结局（膝关节活动范围（ROM）、股四头肌萎缩（QW））和功能结局（IKDC和Tegner-Lysholm评分）。
66.7%的患者PTS小于或等于≤7度。平均PTS角度为6.47±2.40度。影像学上，6个月时PTT无统计学差异。然而，在1年时，A组的PTT（3.98±2.21mm）低于B组（3.03±1.42mm）（P = 0.04）。A组有2例患者在6个月时为III级PTT，其中1例在1年时仍为III级PTT。在平均随访时，A组的IKDC和Tegner-Lysholm评分（81.55±11.4，90.19±5.53）低于B组（86.56±7.2，94.6±4.42），差异有统计学意义（IKDC：P = 0.038，Tegner-Lysholm：P = 0.001）。在1年和平均随访时，A组的ROM显著更低（p = 0.047）。6个月和1年时QW无显著差异。
术前PTS角度较小（≤7）对单纯PCL-R的结局有负面影响，与PTS角度较大（>7）的患者相比，会导致膝关节后方继发性松弛。单纯PCL损伤中胫骨后倾角较小（≤7）的发生率为66.7%。
