METHODS: A literature search was performed using the PubMed, Embase, MEDLINE, and Cochrane Library databases. Inclusion criteria consisted of level I-IV human clinical studies reporting subjective and objective outcomes in patients following surgical management for chronic (>6 weeks from injury) grade III PLC injuries, with a minimum two-year follow-up. The criterion for objective surgical failure was based on post-operative varus stress radiographs and defined as a side-to-side difference of 3 mm or more of lateral gapping.
RESULTS: A total of six studies, consisting of 10 separate cohorts encompassing a total of 230 patients, were identified. PLC reconstruction was performed in all cohorts, with 80 % (n = 8/10) of these cohorts utilising an anatomic reconstruction technique. A failure rate ranging from 4.3 % to 36 % was found. Subgroup analysis revealed a failure rate of 4.3 %-24.2 % for anatomic reconstruction techniques, whereas a 0 %-36 % failure rate was found for non-anatomic reconstruction. Arthrofibrosis was the most common complication (range, 0 %-12.1 %) following surgery. 0 %-8 % of patients required revision PLC surgery.
CONCLUSIONS: PLC reconstruction yields a wide variability in failure rates according to the side-to-side difference of 3 mm or more of lateral gapping on post-operative varus stress radiographs, with low revision rates following anatomic and non-anatomic reconstruction techniques.
METHODS: IV; Systematic Review of Level III and IV studies.
方法:使用PubMed进行了文献检索,Embase,MEDLINE和Cochrane图书馆数据库。纳入标准包括I-IV级人体临床研究,报告慢性(损伤后>6周)III级PLC损伤手术治疗后患者的主观和客观结果。至少随访两年。客观手术失败的标准基于术后内翻应力X线片,并定义为侧向间隙3mm或更大的侧向差异。
结果:共6项研究,由10个单独的队列组成,总共230名患者,已确定。在所有队列中进行PLC重建,这些队列中有80%(n=8/10)使用解剖重建技术。发现故障率为4.3%至36%。亚组分析显示,解剖重建技术的失败率为4.3%至24.2%,而非解剖重建的失败率为0%至36%。关节纤维化是最常见的并发症(范围,0%—12.1%)术后。0%~8%的患者需要进行PLC的翻修手术。
结论:根据术后内翻应力X线片上3mm或更大的侧向间隙的左右差异,PLC重建产生的失败率差异很大,解剖和非解剖重建技术后的翻修率低。
方法:IV;III级和IV级研究的系统评价。