Fahlbusch H, Weiß S, Korthaus A, Akoto R, Krause M, Frosch K H
Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Trauma and Orthopaedic Surgery, Cologne-Merheim Medical Centre (CMMC), University of Witten/Herdecke, Cologne, Germany.
Arch Orthop Trauma Surg. 2024 Dec 21;145(1):79. doi: 10.1007/s00402-024-05619-5.
The failure rate following posterolateral corner reconstruction (PLC) remains high. Previous research indicates that in posterior cruciate ligament (PCL) reconstruction the laxity is affected by the tibial slope (TS). However, there is currently no literature evaluating the impact of TS on surgical outcome in combined reconstruction of PLC/PCL.
This study analyzed 47 patients in a retrospective cohort study who underwent PCL and anatomical PLC reconstruction according to techniques described by Arciero or LaPrade. TS was measured, and patients were divided into two groups: Group A (n = 16) with TS < 8° and Group B (n = 31) with TS ≥ 8°. After a minimum follow-up of 12 months, the side-to-side difference (SSD) of posterior tibial translation (PTT) was assessed using instrumented stability testing (Rolimeter), and various patient-reported outcome measures (IKDC, Lysholm) were collected and compared.
At a mean follow-up of 17.7 ± 4.7 months, group A exhibited a higher SSD of PTT (A 3.9 mm ± 2.1 vs. B: 2.8 mm ± 1.5; p < 0.05). A negative correlation was observed between SSD of PTT and both TS (r = - 0.43; R = 0.18; p < 0.01) and the Lysholm Score (r = - 0.41; R = 0.17; p < 0.01) in the overall cohort. Subgroup analysis revealed a higher Lysholm Score in patients with a postoperative SSD of PTT less than 4 mm (85.7 ± 10.1 vs. 79.2 ± 6.6; p = 0.0006).
In combined PCL and anatomic PLC reconstruction a TS < 8° results in elevated SSD of PTT. A flattened TS is linked to higher remaining SSD of PTT, while lower SSD of PTT is associated with improved clinical outcomes.
Retrospective Cohort Study, IV.
后外侧角重建（PLC）后的失败率仍然很高。先前的研究表明，在重建后交叉韧带（PCL）时，松弛度受胫骨坡度（TS）的影响。然而，目前尚无文献评估TS对PLC/PCL联合重建手术结果的影响。
本研究在一项回顾性队列研究中分析了47例患者，这些患者根据Arciero或LaPrade描述的技术接受了PCL和解剖学PLC重建。测量TS，并将患者分为两组：A组（n = 16），TS < 8°；B组（n = 31），TS≥8°。在至少随访12个月后，使用仪器稳定性测试（旋转计）评估胫骨后移（PTT）的左右差异（SSD），并收集和比较各种患者报告的结局指标（IKDC、Lysholm）。
平均随访17.7±4.7个月时，A组的PTT的SSD更高（A组：3.9 mm±2.1，B组：2.8 mm±1.5；p < 0.05）。在整个队列中，观察到PTT的SSD与TS（r = - 0.43；R = 0.18；p < 0.01）和Lysholm评分（r = - 0.41；R = 0.17；p < 0.01）之间呈负相关。亚组分析显示，术后PTT的SSD小于4 mm的患者的Lysholm评分更高（85.7±10.1对79.2±6.6；p = 0.0006）。
在PCL和解剖学PLC联合重建中，TS < 8°会导致PTT的SSD升高。扁平的TS与较高的PTT剩余SSD相关，而较低的PTT的SSD与改善的临床结果相关。
回顾性队列研究，IV级。
