CLINICAL OUTCOMES AFTER TWO-STAGE BICRUCIATE KNEE LIGAMENT RECONSTRUCTION

ABSTRACT Objective: To correlate clinical and intraoperative findings with the postoperative evaluation of two-stage bicruciate knee ligament reconstruction. Methods: The study was conducted with 25 patients (20 men and 05 women) with mean age of 32.3 years, mean body mass index (BMI) of 26.2, and mean lesion duration of 18.3 months. The treatment consisted of an Inlay reconstruction of the posterior cruciate ligament (PCL) followed by the anterior cruciate ligament (ACL) reconstruction, at least 3 months after the first surgical procedure. Four patients required additional procedures: patellar tendon (02), medial collateral ligament (MCL) (02). Results: With an average follow-up of 24.8 months, 60% of the patients scored zero or + at the posterior drawer test, while 40% scored ++; 60% of patients were evaluated as good/excellent according to the Lysholm scale. Only one patient reached the pre-injury Tegner activity level. Injury duration had a negative influence on functional limitation, vitality, and mental health (SF-36). Conclusion: Although two-stage bicruciate knee ligament reconstruction improved knee stability and self-assessment, 96% of patients did not recover their pre-injury state. In the 36-item short form survey (SF-36), injury duration was inversely correlated with self-assessment of functional capacity, physical limitation, vitality, and mental health. Level of Evidence II, retrospective study.

摘要
目的：将双阶段双十字膝关节韧带重建术的临床、术中发现与术后评估结果进行相关性分析。
方法：本研究共纳入25例患者（20名男性、5名女性），平均年龄32.3岁，平均体质量指数（BMI）26.2，平均损伤病程18.3个月。治疗方案为先实施后交叉韧带（posterior cruciate ligament, PCL）嵌入式重建术，间隔至少3个月后再行前交叉韧带（anterior cruciate ligament, ACL）重建术。其中4例患者需追加额外手术：髌腱修复2例、内侧副韧带（medial collateral ligament, MCL）修复2例。
结果：平均随访时长24.8个月，60%的患者后抽屉试验评分为0或+，40%评分为++；依据Lysholm评分量表，60%的患者评估结果为良好/优秀。仅1例患者恢复至伤前Tegner活动水平。损伤病程对功能受限、活力及心理健康（SF-36）存在负面影响。
结论：尽管双阶段双十字膝关节韧带重建术可改善膝关节稳定性与自我评估结果，但96%的患者未能恢复至伤前状态。在36项简明健康调查问卷（SF-36）中，损伤病程与功能能力、躯体受限、活力及心理健康的自我评估呈负相关。
证据等级：Ⅱ级，回顾性研究。