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首页> 外文期刊>American Journal of Sports Medicine >Anterolateral transtibial posterior cruciate ligament reconstruction combined with anatomical reconstruction of posterolateral corner insufficiency: comparison of single-bundle versus double-bundle posterior cruciate ligament reconstruction over a 2- to 6-year follow-up.
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Anterolateral transtibial posterior cruciate ligament reconstruction combined with anatomical reconstruction of posterolateral corner insufficiency: comparison of single-bundle versus double-bundle posterior cruciate ligament reconstruction over a 2- to 6-year follow-up.

机译：前外侧胫骨后交叉韧带重建结合后外侧角功能不全的解剖重建：单束与双束后交叉韧带重建的比较在2至6年的随访中。

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BACKGROUND: There is a paucity of clinical studies comparing single- and double-bundle posterior cruciate ligament (PCL) reconstruction combined with a posterolateral corner reconstruction. PURPOSE: To compare the clinical outcomes of single- and double-bundle transtibial PCL reconstruction combined with reconstruction of the lateral collateral ligament and popliteus tendon for posterolateral corner insufficiency. STUDY DESIGN: Cohort study; Level of evidence 3. METHODS: The study population consisted of 42 patients for whom a minimum of 2 years of follow-up data were available. The authors compared the clinical outcomes of 2 surgical techniques: a single-bundle technique (23 patients) and a double-bundle technique (19 patients), each combined with reconstruction of the lateral collateral ligament and popliteus tendon for posterolateral corner insufficiency. RESULTS: There was no significant difference between the single- and double-bundle groups in mean side-to-side difference of posterior translation as measured with Telos stress radiography (4.2 +/- 1.7 vs 3.9 +/- 1.6 mm; P = .628). Rates of residual increased laxity greater than 5 mm were 22% in the single-bundle group and 21% in the double-bundle group. Regarding posterolateral rotatory instability, there were no differences between the 2 groups in mean side-to-side difference in the dial test (5.3 degrees +/- 2.7 degrees vs 5.1 degrees +/- 2.4 degrees at 30 degrees of flexion [P = .800]; 6.7 degrees +/- 2.7 degrees vs 6.7 degrees +/- 2.4 degrees at 90 degrees of flexion [P = .917]) or in varus stress radiography (1.2 +/- 1.2 vs 1.3 +/- 1.4 mm; P = .722). The Lysholm knee scores were 85.7 +/- 7.6 in the single-bundle group and 87.7 +/- 7.3 in the double-bundle group, and there was no significant difference between them (P = .392). There was also no difference between the groups in International Knee Documentation Committee knee score (P = .969); from this, the rates of abnormal and severely abnormal were 30% in the single-bundle group and 26% in the double-bundle group. CONCLUSION: In this series, double-bundle PCL reconstruction combined with posterolateral corner reconstruction did not appear to have advantages over single-bundle PCL reconstruction combined with posterolateral corner reconstruction with respect to the clinical outcomes or posterior knee stability.
机译：背景：缺乏临床研究比较单束和双束后十字韧带（PCL）重建与后外侧角重建。目的：比较单束和双束经胫骨PCL重建结合外侧副韧带和pop肌腱重建治疗后外侧角功能不全的临床结果。研究设计：队列研究;证据水平3.方法：研究人群包括42位患者，他们至少有2年的随访数据。作者比较了两种手术技术的临床结果：单束技术（23例患者）和双束技术（19例患者），每例均结合了外侧副韧带和pop肌腱的重建以治疗后外侧角功能不全。结果：用Telos应力射线照相术测得，单束和双束组后平移的左右平均差异无显着差异（4.2 +/- 1.7 vs 3.9 +/- 1.6 mm; P =。 628）。单束组中大于5mm的残余松弛度增加率为22％，双束组为21％。关于后外侧旋转不稳定性，在拨度试验中两组之间的平均左右差异没有差异（屈曲30度时，5.3度+/- 2.7度与5.1度+/- 2.4度[P =。 800];在屈曲90度时为6.7度+/- 2.7度与6.7度+/- 2.4度[P = .917]）或在内翻放射线照相中（1.2 +/- 1.2与1.3 +/- 1.4毫米; P = .722）。单捆组的Lysholm膝关节评分为85.7 +/- 7.6，双捆组的Lysholm膝关节评分为87.7 +/- 7.3，两者之间无显着差异（P = .392）。国际膝关节文献委员会膝关节评分之间也没有差异（P = .969）;由此可见，单捆组异常和严重异常的发生率分别为30％和双捆组26％。结论：在这个系列中，就临床结局或后膝稳定性而言，双束PCL重建结合后外侧角重建似乎不比单束PCL重建结合后外侧角重建具有优势。

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