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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Sequential Changes in Posterior Tibial Translation After Posterior Cruciate Ligament Reconstruction: Risk Factors for Residual Posterior Sagging
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Sequential Changes in Posterior Tibial Translation After Posterior Cruciate Ligament Reconstruction: Risk Factors for Residual Posterior Sagging

机译：后曲脂重建后胫骨翻译后的顺序变化：剩余后荫的危险因素

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Background: Residual posterior sagging may occur after posterior cruciate ligament (PCL) reconstruction (PCLR), yet when it mainly occurs is not fully understood. Purpose: To elucidate sequential changes in radiographic posterior tibial translation (PTT) after PCLR. Study Design: Case-control study; Level of evidence, 3. Methods: The authors retrospectively investigated the radiographic findings from 22 patients who underwent bisocket double-bundle PCLR for isolated PCL injury with at least 2 years of follow-up (mean, 4.5 years; range, 2-10 years). Injury severity was assessed using PTT on lateral radiographs with gravity sag views and was stratified according to side-to-side difference in the tibial-femoral stepoff: grade 1 (&5 mm), grade 2 (5 to &10 mm), or grade 3 (≥10 mm). Measurements were taken preoperatively and then immediately, 3 months, 6 months, 1 year, and ≥2 years postoperatively. The authors also investigated the risk factors for residual posterior sagging, indicated when PTT was ≥5 mm (grade ≥2) at the minimum 2-year follow-up. Results: Preoperatively, 13 patients had a grade 2 injury, and 9 had grade 3 injury. The PTT, restored immediately after PCLR, significantly increased at 3 months ( P & .001) but remained unchanged thereafter ≥2 years. There were 7 cases of postoperative PTT ≥5 mm on radiographs. Patients with residual posterior sagging had significantly larger mean PTT than did those without residual posterior sagging at all time points except for immediately postoperatively (preoperatively, 9.1 ± 1.6 vs 12.2 ± 2.3 mm; 3-month follow-up, 2.7 ± 1.6 vs 7.0 ± 1.8 mm; ≥2-year follow-up, 3.4 ± 1.0 vs 6.5 ± 1.4 mm; P & .001 for all). Multivariate logistic regression analysis showed that preoperative grade 3 injury was independently associated with residual posterior sagging (OR, 26.809; 95% CI, 1.257-571.963; P & .001). Conclusion: The initially reduced postoperative PTT significantly increased within 3 months using conventional rehabilitation protocols, but no progression was observed up to 4.5 years after PCLR. Preoperative grade 3 injury was independently associated with residual posterior sagging.
机译：背景：后曲韧带（PCL）重建（PCLR）之后可能发生残留的后松弛，但是当它主要发生时，不完全理解。目的：在PCLR后阐明射线照相后胫骨翻译（PTT）的顺序变化。研究设计：案例控制研究;证据级别，3.方法：作者回顾性地研究了22例接受Bisocket双束PCLR的22名患者的射线照相结果，其中至少2年的后续行动（平均值，4.5岁;范围，2-10岁）。在具有重力张开视图的横向射线照相上使用PTT进行损伤严重程度，并根据胫骨股阶级的侧侧差异分层：1级（＆amp; 5 mm），2级（5至＆amp; lt ; 10 mm），或3级（≥10mm）。术前进行测量，然后立即进行3个月，6个月，1年和左右左右。作者还调查了残留后松下下垂的危险因素，当时PTT≥5毫米（≥2级）至少为期2年的跟进。结果：术前，13例患者患者患者患者患者，9级患者3级伤害。 PTT，在PCLR后立即恢复，在3个月内显着增加（P＆amp; .001），但此后保持不变≥2岁。在射线照片上有7例术后PTT≥5mm。残留后排放的患者显着较大平均pTT，除了在术后立即（术前，9.1±1.6 Vs 12.2±2.3 mm; 3个月随访，2.7±1.6 Vs 7.0± 1.8毫米;≥2年后续，3.4±1.0 Vs 6.5±1.4 mm; P＆amp; LT; .001全部）。多变量逻辑回归分析表明，术前3级损伤与残留的后垂直（或26.809; 95％CI，1.257-571.963; P＆amp; .001）独立相关。结论：使用常规康复方案，初始降低的术后PTT明显增加，但在PCLR后没有观察到4.5年的进展。术前3级损伤与残留后松下的独立相关。

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