Modified arthroscopic repair of a posterior cruciate ligament tibial avulsion fracture improves IKDC and Lysholm score compared to open reduction.

Autor: Li X; Department of Orthopedics, Lu'an Hospital of Anhui Medical University, Lu'an, 237001, China.; Anhui Medical University, Hefei, 230022, China., Ma Q; Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.; Anhui Medical University, Hefei, 230022, China., Zheng Q; Department of Orthopedics, Lu'an Hospital of Anhui Medical University, Lu'an, 237001, China.; Anhui Medical University, Hefei, 230022, China., Dou Q; Department of Orthopedics, Lu'an Hospital of Anhui Medical University, Lu'an, 237001, China., Zhou L; Department of Orthopedics, Lu'an Hospital of Anhui Medical University, Lu'an, 237001, China., Sun L; Department of Orthopedics, Lu'an Hospital of Anhui Medical University, Lu'an, 237001, China., Shao S; Department of Orthopedics, Lu'an Hospital of Anhui Medical University, Lu'an, 237001, China., Wang Q; Department of Orthopedics, Lu'an Hospital of Anhui Medical University, Lu'an, 237001, China. 13865439600@163.com.
Jazyk: angličtina
Zdroj: Journal of orthopaedic surgery and research [J Orthop Surg Res] 2024 Jun 18; Vol. 19 (1), pp. 362. Date of Electronic Publication: 2024 Jun 18.
DOI: 10.1186/s13018-024-04851-4
Abstrakt: Purpose: The purpose of this study was to analyse the difference between arthroscopic fixation and open reduction internal fixation (ORIF) of posterior cruciate ligament (PCL) tibial avulsion fractures.
Methods: This retrospective study analysed patients with an acute PCL tibial avulsion fracture who underwent surgical treatment at our hospital and follow-up for at least 24 months. Variables based on sex, age, Meyers-McKeever type, surgical method, meniscus tear, external fixation, labour or sports, Lysholm knee score, IKDC score, and KT-1000 value were also recorded. Multifactor unconditional logistic regression and Student's t test with 1:1 propensity score matching (PSM) to remove confounding factors were used for analysis.
Results: Sixty-five cases achieved knee function graded as "good" or better, and 9 cases not. Single-factor analysis indicated that Meyers-McKeever type (χ 2  = 4.669, P = 0.031) and surgical approach (χ 2  = 9.428, P = 0.002) are related to functional outcomes. Multifactorial logistic regression analysis further confirmed that Meyers-McKeever typing (OR = 10.763, P = 0.036, [95% CI 1.174-98.693]) and surgical approach (OR = 9.274, P = 0.008, [95% CI 1.794-47.934]) are independent risk factors affecting prognosis. In addition, PSM verified significant differences in the Lysholm score (t = 3.195, P = 0.006), IKDC score (t = 4.703, P = 0.000) and A-KT/H-KT (t = 2.859, P = 0.012). However, the affected-side KT-1000 value (A-KT, mm, t = 1.225, P = 0.239) and healthy-side KT-1000 value (H-KT, mm, t = 1.436, P = 0.172) did not significantly differ between the two groups. The proportions of cases in which the Lysholm score, IKDC and A-KT/H-KT exceeded the minimal clinically important difference (MCID) were 62.5% (20/32), 62.5% (20/32) and 93.75% (30/32), respectively.
Conclusion: Compared with ORIF, an arthroscopic approach for PCL tibial avulsion fractures achieves better results.
Level of Evidence: Retrospective cohort study; Level II.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje