小胫骨后坡角≤70 （PTS角）对离体PCL重建的预后有负面影响：PTS≤70与> 70度的比较分析。

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2024-12-12 DOI:10.1016/j.knee.2024.11.017

Silvampatti Ramasamy Sundararajan , Owais Ahmed , Rajagopalakrishnan Ramakanth , Terence Dsouza , Mahshook Irfan , Arumugam Palanisamy , Shanmuganathan Rajasekaran

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引用次数: 0

摘要

目的：了解孤立性后十字韧带（PCL）撕裂患者胫骨后斜（PTS）分布的发生率，以及PTS对PCL重建（PCL- r）后影像学、临床和功能结局的影响。方法：63例有症状的孤立性pcl撕裂行PCL-R的患者，根据pts -角度以70度为临界值分为a组（小于≤70度）和b组（大于70度）。所有的病人都采用了同样的方法。比较pts角度对6个月和1年的放射学预后（胫骨后平移（PTT））的影响。比较两组6个月、1年和最后随访时的临床结果（膝关节活动度（ROM）、股四头肌萎缩（QW））和功能结果（IKDC和Tegner-Lysholm评分）。结果：66.7%的患者PTS <≤70度。平均pts角为6.47±2.40°。放射学上，6个月时PTT无统计学差异。1年时，a组PTT（3.98±2.21 mm）小于b组（3.03±1.42 mm）（P = 0.04）。a组2例患者6个月时PTT为iii级，1年时PTT为iii级。平均随访时，a组IKDC和Tegner-Lysholm（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显著降低（p = 0.047）。6个月和1年的QW无显著差异。结论：术前PTS角度较低（≤70）对孤立性PCL-R的预后有负面影响，且与PTS角度较高（bbb70）的患者相比，会导致继发性膝关节后侧松弛。胫骨后小斜度（≤70）在孤立性PCL损伤中的发生率为66.7%。

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Lesser posterior tibial slope angle ≤70 (PTS-Angle) has negative effect on outcome of isolated PCL reconstruction: Comparative analysis of PTS ≤70 vs > 70 degrees

Purpose

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).

Methods

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 7⁰-degrees: group-A (less than ≤7⁰-degree) and group-B (more than >7⁰-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.

Results

PTS of less than ≤7⁰-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.

Conclusion

Lesser preoperative PTS angle (≤7⁰) has a negative effect on the outcome of isolated PCL-R and leads to secondary posterior knee laxity than in patients with higher PTS angle (>7⁰). Incidence of lesser posterior tibial slope (≤7⁰) in isolated PCL injuries is 66.7%.

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.