Trøan Ingrid, Bere Tone, Holm Inger, LaPrade Robert F, Engebretsen Lars, Moatshe Gilbert
Orthopaedic Division, Oslo University Hospital, Oslo, Norway.
University of Oslo, Oslo, Norway.
Am J Sports Med. 2025 Jan;53(1):138-146. doi: 10.1177/03635465241293743.
Multiligament knee injuries (MLKIs) are heterogeneous, and bicruciate knee ligament injuries are considered a serious form of this injury. The current literature tends not to distinguish between single and bicruciate MLKI when reporting outcomes.
To investigate patient-reported outcomes after surgical treatment of MLKI comparing single cruciate MLKI with bicruciate MLKI. The secondary aim was to investigate the influence of different factors on patient-reported outcomes after surgery.
Cohort study; Level of evidence, 3.
This study was designed as a cross-sectional cohort study. Patients who underwent surgical treatment for MLKI at a single level 1 trauma center between January 2013 and December 2020 were included in this study. Patient-reported outcomes included the Tegner score, Lysholm score, International Knee Documentation Committee (IKDC) subjective knee form, Knee injury and Osteoarthritis Outcome Survey (KOOS), and a visual analog scale for pain.
Of the 191 patients meeting the inclusion criteria, 124 (65%) agreed to participate and had a complete data set with a follow-up time at a mean 74 ± 27 months. Patients with single cruciate MLKI (type I) had significantly higher scores for IKDC ( = .007), Lysholm ( = .012), KOOS Pain ( = .04), KOOS Activities of Daily Living ( = .01), KOOS Sport and Recreation ( = .005), KOOS Quality of Life ( = .04), KOOS (which considers the subscales of Pain, Symptoms, Sport and Recreation, and Quality of Life) ( = .01), Tegner ( = .04), and visual analog scale for pain during activity ( = .004) when compared with patients with bicruciate MLKI (type II-type IV). Furthermore, age was significantly associated with a lower IKDC ( = .001), and an increased severity of injury was significantly associated with IKDC ( = .015), KOOS ( = .022), and Lysholm ( = .029) scores.
MLKIs involving a single cruciate ligament had significantly higher patient-reported postoperative outcome measures compared with bicruciate MLKIs. Age and type of injury were important predictors for outcomes. Patients presenting with dislocated knees had lower patient-reported outcomes; however, there was no significant difference in outcomes between bicruciate MLKIs and patients presenting with dislocated knees.
膝关节多韧带损伤（MLKIs）具有异质性，双交叉韧带损伤被认为是这种损伤的一种严重形式。当前文献在报告结果时往往不区分单交叉和双交叉MLKI。
比较单交叉MLKI与双交叉MLKI手术治疗后患者报告的结果。次要目的是研究不同因素对手术后患者报告结果的影响。
队列研究；证据等级，3级。
本研究设计为横断面队列研究。纳入2013年1月至2020年12月在单一一级创伤中心接受MLKI手术治疗的患者。患者报告的结果包括Tegner评分、Lysholm评分、国际膝关节文献委员会（IKDC）主观膝关节评分表、膝关节损伤和骨关节炎结果调查（KOOS）以及疼痛视觉模拟量表。
在191名符合纳入标准的患者中，124名（65%）同意参与并拥有完整数据集，平均随访时间为74±27个月。与双交叉MLKI（II型-IV型）患者相比，单交叉MLKI（I型）患者的IKDC评分（P = 0.007）、Lysholm评分（P = 0.012）、KOOS疼痛评分（P = 0.04）、KOOS日常生活活动评分（P = 0.01）、KOOS运动和娱乐评分（P = 0.005）、KOOS生活质量评分（P = 0.04）、KOOS（综合疼痛、症状、运动和娱乐以及生活质量子量表）评分（P = 0.01）、Tegner评分（P = 0.04）以及活动时疼痛视觉模拟量表评分（P = 0.004）显著更高。此外，年龄与较低的IKDC评分显著相关（P = 0.001），损伤严重程度增加与IKDC评分（P = 0.015）、KOOS评分（P = 0.022）和Lysholm评分（P = 0.029）显著相关。
与双交叉MLKI相比，涉及单交叉韧带的MLKI患者报告的术后结果测量显著更高。年龄和损伤类型是结果的重要预测因素。膝关节脱位患者报告的结果较低；然而，双交叉MLKI与膝关节脱位患者的结果之间没有显著差异。
