目的:本研究的目的是分析关节镜下固定和切开复位内固定(ORIF)治疗后交叉韧带(PCL)胫骨止点撕脱性骨折的差异。
方法:这项回顾性研究分析了在我院接受手术治疗并随访至少24个月的急性PCL胫骨撕脱骨折患者。基于性别的变量,年龄,Meyers-McKeever型,手术方法,半月板撕裂,外固定,劳动或体育,Lysholm膝盖得分,IKDC评分,和KT-1000值也被记录。采用多因素非条件逻辑回归和1:1倾向评分匹配(PSM)的Student\'st检验来去除混杂因素进行分析。
结果:65例膝关节功能达到“良好”或更好,9个案例没有。单因素分析显示Meyers-McKeever分型(χ2=4.669,P=0.031)和手术入路(χ2=9.428,P=0.002)与功能结局相关。多因素logistic回归分析进一步证实Meyers-McKeever分型(OR=10.763,P=0.036,[95%CI1.174-98.693])和手术方式(OR=9.274,P=0.008,[95%CI1.794-47.934])是影响预后的独立危险因素。此外,PSM验证了Lysholm评分的显着差异(t=3.195,P=0.006),IKDC评分(t=4.703,P=0.000)和A-KT/H-KT(t=2.859,P=0.012)。然而,受影响侧KT-1000值(A-KT,mm,t=1.225,P=0.239)和健康侧KT-1000值(H-KT,mm,t=1.436,P=0.172)两组之间没有显着差异。Lysholm评分的病例比例,IKDC和A-KT/H-KT超过最小临床重要差异(MCID)为62.5%(20/32),62.5%(20/32)和93.75%(30/32),分别。
结论:与ORIF相比,关节镜下PCL胫骨止点撕脱骨折治疗效果较好.
方法:回顾性队列研究;II级。
OBJECTIVE: 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 (χ2 = 4.669, P = 0.031) and surgical approach (χ2 = 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.
CONCLUSIONS: Compared with ORIF, an arthroscopic approach for PCL tibial avulsion fractures achieves better results.
METHODS: Retrospective cohort study; Level II.