Kondo Eiji, Nishida Yoshio, Joutoku Zenta, Kawamura Daisuke, Iwasaki Koji, Matsuoka Masatake, Onodera Tomohiro, Momma Daisuke, Yagi Tomonori, Iwasaki Norimasa, Yasuda Kazunori
Centre for Sports Medicine Hokkaido University Hospital Sapporo Japan.
Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine Hokkaido University Sapporo Japan.
J Exp Orthop. 2025 Jun 5;12(2):e70295. doi: 10.1002/jeo2.70295. eCollection 2025 Apr.
The purpose of the study was to determine whether the knee stability is better with single-bundle (SB) or double-bundle (DB) posterior cruciate ligament (PCL) reconstruction. The hypothesis was that DB PCL reconstruction in isolated and multiple ligament knee injuries may be significantly better in the posterior laxity than SB procedure.
A retrospective study was conducted with 51 patients who underwent PCL reconstruction. Seventeen cases required isolated PCL reconstruction, and the others had the following additional ligament reconstruction; 25 cases required anterior cruciate ligament reconstruction, 11 cases required posteromedial corner reconstruction, and eight cases required posterolateral corner reconstruction. All patients were divided into two groups: In Group S, 20 patients underwent SB PCL reconstruction. In Group D, 31 patients underwent DB PCL reconstruction. Clinical outcomes were evaluated at 2 years or more after surgery. The paired Student -test, Mann-Whitney -test and chi-square test were used to test for significance.
The postoperative anterior-posterior (AP) translation at 20° and 70° and the relative femur-tibia position in the anterior and posterior stress radiographs at 90° significantly improved postoperatively in both groups. The postoperative side-to-side differences in AP translation at 20° and 70° showed no significant difference between the groups. The relative femur-tibia position in the posterior stress radiographs at 90° was significantly less ( < 0.0001) in Group D (mean, SD, 95% confidence interval; 54.0%, 5.2%, 52.1%-55.8%) than in Group S (43.8%, 5.7%, 41.3%-46.3%). There were no significant differences in the valgus and varus laxities, Lysholm score, International Knee Documentation Committee (IKDC) evaluation, Knee Injury and Osteoarthritis Outcome Score (KOOS), Tegner scale, and complications between the two procedures.
There were no significant differences in the Lysholm score, IKDC evaluation, and KOOS, Tegner scale between both groups although there was significantly better posterior stability in 90° flexion with DB reconstruction.
Level III.
本研究的目的是确定单束（SB）或双束（DB）后交叉韧带（PCL）重建术后膝关节稳定性是否更好。假设是在孤立性和多韧带损伤膝关节中，DB PCL重建术后的后向松弛度可能比SB手术明显更好。
对51例行PCL重建术的患者进行回顾性研究。17例需要孤立性PCL重建，其余患者还进行了以下附加韧带重建；25例需要前交叉韧带重建，11例需要后内侧角重建，8例需要后外侧角重建。所有患者分为两组：S组，20例患者接受SB PCL重建。D组，31例患者接受DB PCL重建。在术后2年或更长时间评估临床结果。采用配对t检验、Mann-Whitney检验和卡方检验进行显著性检验。
两组术后在20°和70°时的前后（AP）平移以及在90°时前后应力X线片上的相对股骨-胫骨位置均有显著改善。两组在20°和70°时AP平移的术后左右差异无显著差异。D组在90°时后应力X线片上的相对股骨-胫骨位置（均值、标准差、95%置信区间；54.0%，5.2%，52.1%-55.8%）明显低于S组（43.8%，5.7%，41.3%-46.3%）（<0.0001）。两种手术在内外翻松弛度、Lysholm评分、国际膝关节文献委员会（IKDC）评估、膝关节损伤和骨关节炎疗效评分（KOOS）、Tegner量表及并发症方面均无显著差异。
两组在Lysholm评分、IKDC评估、KOOS、Tegner量表方面无显著差异，尽管DB重建在90°屈曲时后向稳定性明显更好。
III级。
