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Abstract：
OBJECTIVE: Arthroscopic reconstruction techniques for higher-grade posterolateral corner (PLC) injuries (Fanelli Type B, PoLIS LI-B) have not yet been validated in clinical studies. The open reconstruction technique described by Arciero is well-established and showed good restoration of joint stability in previous studies. This study aimed to compare clinical outcomes of this established open surgery technique to a newly developed arthroscopic technique in a prospective randomized clinical trial.
METHODS: Between 2019 and 2021, this study focused on chronic high-grade PLC injuries (Fanelli Type B, PoLIS LI-B). Group A consisted of patients treated with conventional open surgery following Arciero\'s technique, while Group B included patients treated with Arciero\'s arthroscopic technique. All cases underwent additional PCL reconstruction. After a minimum 12-month follow-up, clinical scores and objective stability assessments were compared between the groups.
RESULTS: In total, 26 (group A 12, group B 14) eligible patients with a mean follow-up of 14.9 ± 7.2 months were evaluated in the present study. Knee stability and patient-reported outcome scores (PROMS) were significantly improved when comparing pre- and post-operative values (p < 0.0001). No clinically relevant differences in PROMS (Lysholm: A 83.9 ± 11.4 vs. B 85.3 ± 13.8; IKDC: A 76.91 ± 12.6 vs. B 76.8 ± 15.7) were shown in both groups. Additionally, no statistically significant differences were detected between groups with respect to external rotation, range of motion and instrumental stability testing. Arthroscopic reconstruction showed significantly shorter operation time (p = 0.0109). There were no clinical failures or neurovascular complications of the surgical procedures.
CONCLUSIONS: Both surgical techniques for isolated chronic PLC Fanelli Type B injuries significantly improved the knee stability, were equivalent with respect to PROMs and led to good clinical results. However, arthroscopic PLC reconstruction was associated with a shorter surgery time compared to open PLC reconstruction. Therefore, arthroscopic PLC reconstruction may be a viable option in the hands of an experienced surgeon.
METHODS: Prospective cohort study, II.
METHODS: Between 2019 and 2021, this study focused on chronic high-grade PLC injuries (Fanelli Type B, PoLIS LI-B). Group A consisted of patients treated with conventional open surgery following Arciero\'s technique, while Group B included patients treated with Arciero\'s arthroscopic technique. All cases underwent additional PCL reconstruction. After a minimum 12-month follow-up, clinical scores and objective stability assessments were compared between the groups.
RESULTS: In total, 26 (group A 12, group B 14) eligible patients with a mean follow-up of 14.9 ± 7.2 months were evaluated in the present study. Knee stability and patient-reported outcome scores (PROMS) were significantly improved when comparing pre- and post-operative values (p < 0.0001). No clinically relevant differences in PROMS (Lysholm: A 83.9 ± 11.4 vs. B 85.3 ± 13.8; IKDC: A 76.91 ± 12.6 vs. B 76.8 ± 15.7) were shown in both groups. Additionally, no statistically significant differences were detected between groups with respect to external rotation, range of motion and instrumental stability testing. Arthroscopic reconstruction showed significantly shorter operation time (p = 0.0109). There were no clinical failures or neurovascular complications of the surgical procedures.
CONCLUSIONS: Both surgical techniques for isolated chronic PLC Fanelli Type B injuries significantly improved the knee stability, were equivalent with respect to PROMs and led to good clinical results. However, arthroscopic PLC reconstruction was associated with a shorter surgery time compared to open PLC reconstruction. Therefore, arthroscopic PLC reconstruction may be a viable option in the hands of an experienced surgeon.
METHODS: Prospective cohort study, II.
摘要：
目标：用于较高级后外侧角（PLC）损伤的关节镜重建技术（FanelliB型，PoLISLI-B）尚未在临床研究中得到验证。Arciero描述的开放式重建技术已得到完善，并且在先前的研究中显示出关节稳定性的良好恢复。这项研究旨在在一项前瞻性随机临床试验中将这种已建立的开放手术技术与新开发的关节镜技术的临床结果进行比较。
方法：在2019年至2021年之间，这项研究的重点是慢性高级别PLC损伤(FanelliB型，PoLISLI-B）。A组包括采用Arciero技术进行常规开放手术治疗的患者，而B组包括接受Arciero关节镜技术治疗的患者。所有病例均接受了额外的PCL重建。经过至少12个月的随访，比较两组间的临床评分和客观稳定性评估.
结果：总计，在本研究中评估了26例（A组12，B组14）符合条件的患者，平均随访时间为14.9±7.2个月。当比较术前和术后值时，膝关节稳定性和患者报告的结果评分（PROMS）显着改善（p<0.0001）。PROMS没有临床相关差异（Lysholm：A83.9±11.4与B85.3±13.8；IKDC：A76.91±12.6vs.两组均显示B76.8±15.7）。此外,在外部旋转方面，组间没有发现统计学上的显著差异，运动范围和仪器稳定性测试。关节镜重建显示手术时间明显缩短（p=0.0109）。手术没有临床失败或神经血管并发症。
结论：两种手术技术治疗孤立性慢性PLCFanelliB型损伤可显著改善膝关节稳定性，与PROM相当，并导致良好的临床结果。然而,与开放式PLC重建相比,关节镜下PLC重建手术时间更短.因此,在有经验的外科医生手中，关节镜PLC重建可能是一个可行的选择。
方法：前瞻性队列研究，II.
方法：在2019年至2021年之间，这项研究的重点是慢性高级别PLC损伤(FanelliB型，PoLISLI-B）。A组包括采用Arciero技术进行常规开放手术治疗的患者，而B组包括接受Arciero关节镜技术治疗的患者。所有病例均接受了额外的PCL重建。经过至少12个月的随访，比较两组间的临床评分和客观稳定性评估.
结果：总计，在本研究中评估了26例（A组12，B组14）符合条件的患者，平均随访时间为14.9±7.2个月。当比较术前和术后值时，膝关节稳定性和患者报告的结果评分（PROMS）显着改善（p<0.0001）。PROMS没有临床相关差异（Lysholm：A83.9±11.4与B85.3±13.8；IKDC：A76.91±12.6vs.两组均显示B76.8±15.7）。此外,在外部旋转方面，组间没有发现统计学上的显著差异，运动范围和仪器稳定性测试。关节镜重建显示手术时间明显缩短（p=0.0109）。手术没有临床失败或神经血管并发症。
结论：两种手术技术治疗孤立性慢性PLCFanelliB型损伤可显著改善膝关节稳定性，与PROM相当，并导致良好的临床结果。然而,与开放式PLC重建相比,关节镜下PLC重建手术时间更短.因此,在有经验的外科医生手中，关节镜PLC重建可能是一个可行的选择。
方法：前瞻性队列研究，II.
