Objective: To investigate effect of posterior oblique ligament (POL) repair on the rotational stability of the knee joint for the medial collateral ligament (MCL) combined with anterior cruciate ligament (ACL) ruptures.
Methods: The clinical data of 50 patients (50 knees) with grade-3 MCL-ACL combined injuries who met the selection criteria between January 2013 and December 2015 were retrospectively analyzed. All ACLs were reconstructed with autogenous tendon and the superficial and deep layers of MCLs were sutured; then, POLs were also sutured in 25 patients of repair group and only received conservation treatment postoperatively in 25 patients of conservation group. There was no significant difference in gender, age, disease duration, and preoperative KT-1000 measuring, medial joint space opening, International Knee Documentation Committee (IKDC) score, visual analogue scale (VAS) score, and knee range of motion between the two groups ( P>0.05).
Results: All incisions of the two groups healed by first intention, no surgical related complications occurred. All patients were followed up, with follow-up time of 28-56 months (mean, 38.1 months) in repair group and 26-55 months (mean, 29.1 months) in conservation group. At last follow-up, the IKDC score, VAS score, KT-1000 measuring, medial joint space opening, and knee range of motion significantly improved in the two groups when compared with preoperative ones ( P<0.05); but there was no significant difference between the two groups ( P>0.05). The Slocum test showed that there was no instability of the anterior medial rotation in the two groups.
Conclusion: The POL repair can't obtain more medial stability after ACL reconstruction and MCL repair (superficial and deep layers) for patients who have MCL-ACL combined injuries.
目的: 探讨膝关节内侧副韧带合并前交叉韧带损伤时，后斜韧带缝合修复与否对膝关节旋转稳定性的影响。.
方法: 回顾分析 2013 年 1 月—2015 年 12 月收治的符合选择标准的 50 例（50 膝）合并前交叉韧带损伤的 3 度膝关节内侧副韧带损伤患者临床资料。行前交叉韧带自体肌腱重建、内侧副韧带浅层及深层缝合修复后，其中 25 例同时缝合修复后斜韧带（缝合组），25 例不作手术处理（保守治疗组）。两组患者性别、年龄、病程及术前 KT-1000 测量、内侧关节间隙开口、国际膝关节文献委员会（IKDC）评分、疼痛视觉模拟评分（VAS）、膝关节活动度等一般资料比较，差异均无统计学意义（ P>0.05），具有可比性。.
结果: 术后两组患者切口均Ⅰ期愈合，无手术相关并发症发生。患者均获随访，缝合组随访时间 28～56 个月，平均 38.1 个月；保守治疗组为 26～55 个月，平均 29.1 个月。末次随访时，两组患者膝关节 IKDC 评分、VAS 评分、KT-1000 测量、内侧关节间隙开口以及膝关节活动度均较术前明显改善（ P<0.05）；组间比较差异无统计学意义（ P>0.05）。Slocum 试验检查显示两组膝关节均无前内侧旋转不稳定。.
结论: 对于合并前交叉韧带损伤的膝关节内侧副韧带损伤患者，采用前交叉韧带重建及内侧副韧带浅层及深层缝合后，后斜韧带修复与否对恢复膝关节内侧稳定性无明显影响。.
Keywords: Medial instability of knee; ligament repair; medial collateral ligament; posterior oblique ligament.