Clinical Effect Observation Of Internal Bracing For Posterior Cruciate Ligament Reconstruction

Objective: As a novel fixation technique for ligament reinforcement,internal bracing technique has been widely applied to the reconstruction of ligaments such as anterior cruciate ligament and medial patellofemoral ligament etc and has achieved substantial biomechanical statistics and clinical outcomes.However,its clinical efficacy reports in the application of posterior cruciate ligament reconstruction are relatively limited.The purpose of this study was to explore the clinical efficacy of utilizing internal bracing technique in the reconstruction of posterior cruciate ligament and to provide some reference for surgeons to choose the relevant methods and protocols of ligament reconstruction.Methods: The clinical and imaging data of 45 patients with rupture of posterior cruciate ligament and underwent PCL reconstruction admitted to the First Affiliated Hospital of China Medical University from January 2019 to January 2022 were retrospectively analyzed.The patients were divided into internal bracing group and traditional transtibial group by different posterior cruciate ligament fixation techniques.25 of them were enrolled in internal bracing group(17 males,mean age 34.4;8 females,mean age 46.5)while 20 patients were enrolled in traditional transtibial group(15 males,mean age 41.1;5 females,mean age 50).Preoperative and 1-year postoperative IKDC score,Lysholm score and Tegner score were recorded as knee function criteria while preoperative and 1-year postoperative side-to-side difference of tibial posterior translation were recorded as knee stability criteria.Comparing the evaluation criteria of the two groups of patients one year after operation and the evaluation criteria of patients in each group compared with preoperative.Results: Compared with traditional transtibial technique,the IKDC score and the Lysholm score at 1 year after operation were better(all P<0.05),which were 89.76±3.32 and92.28±3.71 respectively.There was statistically significant difference before and after surgery in each group(all P<0.001).There was no statistically significant difference in the Tegner score between the two groups at 1 year after operation(P>0.05),but there was statistically significant difference in each group compared with preoperative(all P<0.001).The mean side-to-side difference of tibial posterior translation 1 year after operation in the internal bracing group was significantly better than that in the traditional transtibial group with the value of 1.62±0.36 mm.There was statistically significant difference between the two groups,suggesting that the stability of the knee in internal bracing group was significantly better than that in the traditional group(P<0.001).The postoperative knee stability in both groups was significantly improved compared with preoperative(all P<0.001).Conclusion: Internal bracing technique for posterior cruciate ligament reconstruction can achieve satisfactory clinical outcomes and better restore knee stability,which is helpful to allow early mobilization and quick rehabilitation of patients.