目的:后交叉韧带(PCL)是至关重要的膝关节稳定器。虽然PCL损伤很少见,高能创伤会导致完全破裂,伴随受伤需要手术。本研究旨在调查人口统计学,伴随的伤害,以及在大量患者样本中,由于高能量创伤而接受PCL重建的患者的术后并发症。
方法:使用来自全国个人健康记录系统的数据对2016年至2022年接受PCL重建的患者进行回顾性评估。患者人口统计学,损伤机制,相关骨折,软组织损伤,术后并发症从病人记录中收集,临床访视,和手术笔记。高能创伤后PCL受伤的人(车祸,从高处坠落,摩托车事故),至少随访1年。
结果:该研究包括416例患者,平均年龄32.4岁。孤立的PCL损伤(n=97,23.3%)的频率低于多韧带损伤(n=319,76.7%)。大多数病例采用单期手术(86.8%),少数病例(13.2%)进行分期手术。创伤机制与多韧带受累之间没有关系,伴随的伤害,或术后并发症。车祸后的手术更有可能作为分期手术发生(p=0.014)。此外,分期手术和年轻患者(≤18岁)的并发症发生率明显较高(p=0.009).
结论:高能创伤引起的PCL损伤通常与多韧带受累的严重并发膝关节损伤相关。车祸后的PCL重建更有可能上演。这些发现强调了在处理这些病例时仔细考虑以尽量减少并发症的重要性。特别是在年轻的年龄组。
方法:三级。
OBJECTIVE: The posterior cruciate ligament (PCL) is a vital knee stabilizer. While PCL injuries are rare, high-energy traumas can lead to total ruptures, with accompanying injuries requiring surgery. This study aims to investigate the demographics, concomitant injuries, and postoperative complications of patients who underwent PCL reconstruction due to high-energy trauma in a large patient sample.
METHODS: Patients who underwent PCL reconstruction from 2016 to 2022 were retrospectively evaluated using data from a nationwide personal health recording system. Patient demographics, injury mechanisms, associated fractures, soft tissue injuries, and postoperative complications were collected from patient notes, clinical visits, and surgical notes. Individuals with a PCL injury following high-energy trauma (car accident, falls from height, motorcycle accident) with a minimum follow-up of 1 year were included in the study.
RESULTS: The study included 416 patients with a mean age of 32.4 years. Isolated PCL injuries (n = 97, 23.3%) were observed less frequently than multiple-ligament injuries (n = 319, 76.7%). Most cases were treated with single-stage surgery (86.8%), while staged surgeries were performed in a minority of cases (13.2%). There was no relationship between trauma mechanisms and multiple-ligament involvement, accompanying injuries, or postoperative complications. Surgeries following car accidents were more likely to occur as staged surgeries (p = 0.014). Additionally, the complication rates for staged surgeries and younger patients (≤ 18 years) were significantly higher (p = 0.009).
CONCLUSIONS: High-energy trauma-induced PCL injuries are often associated with severe concurrent knee injuries with multiple ligament involvement. PCL reconstructions following car accidents are more likely to be staged. These findings highlight the importance of careful consideration in managing these cases to minimize complications, particularly in younger age groups.
METHODS: Level III.