A clinical comparative study on the reconstruction of posterior cruciate ligament with single tendon autograft plus high-strength braid or not

Abstract

Objective To observe the difference of the clinical effect of using high-strength woven suture or not in the reconstruction of posterior cruciate ligament (PCL) with single tendon autograft under arthroscope. Methods The clinical data of 40 patients with posterior cruciate ligament rupture and ligament reconstruction admitted to Shengjing Hospital Affiliated to China Medical University from 2017 to 2018 were analyzed retrospectively.According to whether or not to add Arthrex ar-7200 (Arthrex, Naples, FL, USA) braided suture in the autogenous hamstring graft, the patients were divided into test group (17 cases) and control group (23 cases). The posterior drawer test (PDT) was used as the knee joint stability test to evaluate the knee function, IKDC score, Lysholm score and Tegner score were used as the evaluation criteria.The evaluation results of the knee joint in the experimental group and the control group were compared before and one year after the operation, and the evaluation results of the knee joint in the two groups were compared one year after the operation and one year before the operation Results Functional aspects of knee joint: The Lysholm score of the experimental group was expressed by median (quartile) 1 year before and after operation.Lysholm scores of the trail group were 64 (40, 81) and 84 (73, 87) preoperative and postoperative, respectively, the control group were 68 (48, 78) and 80 (70, 90) respectively, there was statistically difference before and after surgery (Z value was -2.535 and -3.576, P value was 0.011 and 0.05). The Tegner score of the experimental group before and 1 year after operation was expressed as the median [quartile], which was 2.0 (1.0, 2.5), 6.0 (5.0, 7.5) respectively, and that of the control group was 2.0 (1.0, 3.0), 6.0 (4.0, 7.0) respectively.There was statistically significant difference between the two groups before and after operation (Z value was -3.397, -4.122, all P 0.05). One year after operation, the IKDC scores of the two groups were significantly improved (Z values were -3.750, -4.234, all P 0.05). There was no significant difference between the two groups in the postoperative drawer test (P>0.05); one year after the operation, the stability of the two groups was significantly improved (Z values were -3.674, -4.083, all P<0.01), and the stability of the experimental group was significantly better than that of the control group(Z=0.156, P=0.039). Conclusion Posterior cruciate ligament reconstruction with autologous hamstring muscle can achieve satisfactory clinical results, and placing high-strength braided sutures in the graft is more conducive to the recovery of knee joint stability. Key words: Posterior cruciate ligament; Ligament reconstruction; Arthroscopy; Autogenous hamstring tendon