Suture tape augmentation improves posterior stability after isolated posterior cruciate ligament reconstruction using hamstring tendon autograft with single-bundle transtibial technique

Hangzhou Zhang, Jian Wang, Yuzhong Gao, Peng Zheng, Lianhai Gong
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Abstract

Purpose

The purpose of this study was to assess whether posterior cruciate ligament reconstruction (PCLR) suture tape augmentation can yield more stability after isolated PCLR.

Methods

A prospective database was retrospectively reviewed to identified patients that underwent primary isolated PCLR (control study) or isolated PCLR with suture tape augmentation (study group) from January 2016 to September 2020. the subjective International Knee Documentation Committee Subjective (IKDC) Knee, Lysholm and Tegner scores, posterior draw tests, as well as posterior stress radiographs and return to sports activity rates. The minimal clinically important difference (MCID) was used to evaluate the clinically relevance (subjective IKDC, Lysholm and Tegner scores).

Results

59 were included in this analysis (28 patients in control group, 31 patients in study group). The average length of follow-up was similar between the study and control groups (48.6 vs 47.9months; p=0.800). Knee function, in terms of subjective IKDC (study vs. control: 85.1±6.4 vs. 79.8±6.4; P=0.002), Lysholm (study vs. control: 86.3±7.4 vs. 80.8±7.4; P=0.005) and Tegner (study vs. control: 7.0±1.4 vs. 5.6±1. 7; P=0.006) scores, was significantly improved in the study group. However, the differences between control group and study group were less than the MCID in the subjective IKDC score and Lysholm score. 21.4% (6/28) and 48.4% of patients (15/31) in the control and study groups, respectively, returned to the preinjury sports activity levels (P=0.031). At last follow-up, the mean side-to-side differences in posterior laxity was significantly improved in the study group compared with the control patients (study vs. control: 1.52±0.70 mm vs. 3.17±2.01 mm; p<0.01).

Conclusions

Primary isolated PCLR with suture tape augmentation provides better posterior stability than PCLR without suture tape augmentation at a minimum 2 years follow-up. No differences observed between the groups in the percentage of patients who met or exceeded the MCID in subjective IKDC and Lysholm score.

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使用腘绳肌腱自体移植物和单束经胫技术进行孤立后交叉韧带重建后,缝合带增量改善了后部稳定性
本研究的目的是评估后交叉韧带重建(PCLR)缝合带增量术是否能在孤立PCLR术后获得更高的稳定性。方法回顾性审查了前瞻性数据库,确定了2016年1月至2020年9月期间接受原发性孤立PCLR术(对照组)或缝合带增量术的孤立PCLR术(研究组)的患者。研究组患者接受了国际膝关节文献委员会主观(IKDC)膝关节、Lysholm 和 Tegner 评分、后方牵引测试、后方应力X光片和运动恢复率。采用最小临床意义差异(MCID)来评估临床相关性(IKDC、Lysholm 和 Tegner 主观评分)。结果59例患者被纳入分析(对照组28例,研究组31例)。研究组和对照组的平均随访时间相似(48.6 个月 vs 47.9 个月;P=0.800)。从主观 IKDC(研究组 vs. 对照组:85.1±6.4 vs. 79.8±6.4;P=0.002)、Lysholm(研究组 vs. 对照组:86.3±7.4 vs. 80.8±7.4;P=0.005)和 Tegner(研究组 vs. 对照组:7.0±1.4 vs. 5.6±1.7;P=0.006)评分来看,研究组的膝关节功能明显改善。然而,在主观 IKDC 评分和 Lysholm 评分方面,对照组和研究组之间的差异小于 MCID。对照组和研究组分别有 21.4% (6/28)和 48.4% (15/31)的患者恢复到了受伤前的运动活动水平(P=0.031)。在最后一次随访中,与对照组患者相比,研究组患者后方松弛的平均侧向差异明显改善(研究组与对照组:1.52±0.70 mm vs. 3.17±2.01 mm;P<0.01)。在主观IKDC和Lysholm评分达到或超过MCID的患者比例方面,观察到两组之间没有差异。
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