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Medial collateral ligament (MCL) reconstruction results in improved medial stability: results from the Danish knee ligament reconstruction registry (DKRR).

内侧副韧带 (MCL) 重建可改善内侧稳定性: 来自丹麦膝关节韧带重建注册中心 (DKRR) 的结果。

  • 影响因子:3.28
  • DOI:10.1007/s00167-019-05535-x
  • 作者列表:"Lind M","Jacobsen K","Nielsen T
  • 发表时间:2020-03-01
Abstract

PURPOSE:The aim of this study was to compare outcome data after isolated and combined (MCL) plus anterior cruciate ligament (ACL) reconstruction based on objective and subjective measures using data from the (DKRR). There are only a few small-sized case studies on outcomes after MCL reconstruction. MCL reconstruction was hypothesised to improve both objective and subjective outcomes. METHODS:All patients who were registered in the DKRR between 2005 and 2016 (N = 25,281) and who underwent isolated ACL (n = 24,683), isolated MCL (n = 103) or combined MCL plus ACL (n = 495) reconstructions were retrospectively identified. Objective (valgus knee stability and sagittal knee laxity) and subjective (Knee Injury and Osteoarthritis Outcome Score (KOOS) and Tegner activity scale score) outcomes in these three cohorts were evaluated at the 1-year follow-up by comparing pre- and post-operative values. RESULTS:Medial stability improved significantly pre- to post-operatively after both isolated MCL and combined MCL plus ACL reconstruction, with 26 (53%) and 195 (69%) of the patients, respectively, having normal valgus stability (0-2 mm laxity). Sagittal stability was similar after MCL plus ACL reconstruction and isolated ACL reconstruction (1.7 and 1.5 mm, respectively). At the 1-year follow-up, although the KOOS of the patients in the isolated MCL and combined MCL plus ACL reconstruction cohorts improved significantly, they were lower than those of the patients in the isolated ACL reconstruction cohort. CONCLUSION:Both isolated MCL reconstruction and combined MCL plus ACL reconstruction resulted in significant and clinically relevant improvements in the subjective outcomes from pre-operative conditions to the 1-year follow-up. Valgus stability also improved significantly, with two-thirds of patients obtaining normal valgus stability after MCL reconstruction. Subjective outcomes were similar between isolated MCL reconstruction and combined MCL plus ACL reconstructions, but were poorer than isolated ACL reconstructions. LEVEL OF EVIDENCE:Level III.

摘要

目的: 本研究的目的是比较分离和联合 (MCL) 加前交叉韧带 (ACL) 后的结果数据基于客观和主观测量的重建,使用 (DKRR) 的数据。关于MCL重建后的结果只有少数小型病例研究。假设MCL重建可改善客观和主观结局。 方法: 所有在 2005 年至 2016 年期间登记在DKRR中的患者 (n = 25,281) 和接受孤立性ACL (n = 24,683) 、孤立性MCL (n = 103) 的患者或联合MCL加ACL (n = 495) 重建进行回顾性鉴定。客观 (膝外翻稳定性和膝矢状面松弛) 和主观 (膝关节损伤和骨关节炎结局评分 (KOOS) 和Tegner活动量表评分) 在 1 年随访时,通过比较术前和术后的数值来评价这三个队列的结局。 结果: 孤立MCL和联合MCL加ACL重建术后患者的内侧稳定性均显著改善,分别为 26 例 (53%) 和 195 例 (69%)。具有正常的外翻稳定性 (0-2毫米松弛)。MCL加ACL重建与孤立ACL重建后矢状位稳定性相似 (分别为 1.7 和 1.5毫米)。在 1 年的随访中,尽管孤立性MCL和MCL联合ACL重建队列中患者的KOOS显著改善,它们低于孤立性ACL重建队列中的患者。 结论: 从术前情况到 1 年随访,孤立性MCL重建和联合MCL加ACL重建均导致主观结局的显著和临床相关改善。外翻稳定性也明显改善,3分之2 的患者在MCL重建后获得正常的外翻稳定性。孤立MCL重建与联合MCL加ACL重建之间的主观结局相似,但比孤立ACL重建更差。 证据级别: III级。

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影响因子:4.13
发表时间:2020-01-01
DOI:10.1002/acr.23824
作者列表:["Chen SK","Liao KP","Liu J","Kim SC"]

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DOI:10.1002/acr.23827
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