General data of patients
A total of 26 patients were enrolled in this study, with an average age of 36.2 years (from 19 to 54), including 19 males and 7 females. There were 12 cases of traffic injury and 14 cases of sports injury. The average time from injury to surgery was 12 days (from 7 to 24 days). Preoperative posterior drawer tests were positive in all patients before surgery, among them, there were 17 patients with grade 2 posterior laxity and 9 patients with grade 3 posterior laxity. Two patients had a longitudinal tear of the posterior horn of the medial meniscus and body, and three patients had partial injury of the medial collateral ligament. The mean follow-up time after surgery was 12.4 months (from 6 months to 19 months). There were no significant differences in baseline patient demographics between the two groups in terms of age, sex, the average time from injury to surgery, and type of surgery (P >0.05) (Table 1).
Table 1. General information of patients.
|
Control group
n=13
|
Experimental group
n=13
|
P
|
Age (years)
|
38
|
36
|
0.248
|
Gender
|
|
|
|
Male
|
9
|
10
|
0.936
|
Female
|
4
|
3
|
0.940
|
Average time from injury to surgery(days)
|
13.5
|
12.6
|
0.185
|
Type of injury
|
|
|
|
Traffic injury
|
5
|
7
|
0.241
|
Sports injury
|
8
|
6
|
0.266
|
Preoperative posterior drawer tests
|
|
|
|
grade 2 posterior laxity
|
9
|
8
|
0.835
|
grade 3 posterior laxity
|
4
|
5
|
0.862
|
There were no differences in knee range of motion, Lysholm score, IKDC score, and KT-1000 score between the two groups before surgery.
There were no differences between the experimental group and the control group in IKDC score(54.1±6.2 vs 53.2±7.1,P =0.812), Lysholm score(37.5±4.1 vs 36.8±2.5,P=0.636), KT-1000 score(9.8±0.6 mm vs 9.6±0.4 mm,P =0.401), and ROM (30±4.5° vs 31±3.7°,P=0.723)before surgery (Table 2.).
Table 2. Comparison of knee range of motion, Lysholm score, IKDC score and KT-1000 score between the experimental group and the control group pre- and post- operation.
Time
|
Variable
|
Control group
|
Experimental group
|
P
|
Preoperative
|
Knee range of motion
|
31±3.7°
|
30±4.5°
|
0.723
|
|
Lysholm score
|
36.8±2.5
|
37.5±4.1
|
0.636
|
|
IKDC score
|
53.2±7.1
|
54.1±6.2
|
0.812
|
|
KT-1000 score (mm)
|
9.6±0.4
|
9.8±0.6
|
0.401
|
Final follow-up
|
Knee range of motion
|
131±4.2°
|
133.5±6.3°
|
0.820
|
|
Lysholm score
|
81.5±3.2
|
84.3±5.2
|
0.915
|
|
IKDC score
|
83.6±3.7
|
84.5±5.1
|
0.799
|
|
KT-1000 score
|
1.7±0.5
|
1.6±0.4
|
0.827
|
IKDC: International Knee Documentation Committee.
The operation time of the experimental group was less than that of the control group.
The average operation time in the experimental group was 59.5 + 10.6 minutes, which was significantly shorter than that in the control group (96.8 + 13.7 minutes) (P < 0.05). In the control group, one patient suffered from an intraoperative collateral ligament injury and underwent primary collateral ligament repair.
All patients had good outcomes postoperatively.
Postoperative re-examination of knee CT and X-ray showed that the fracture fragments were well fixed in the control group (Fig. 3) and experimental group (Fig. 5). Postoperative drawer tests were negative in all patients at final follow-up. The fracture was all healed 2 months after the operation. All patients regained a satisfactory knee range of motion and the flexion and extension function (Fig. 6). And all patients were satisfied with the results of surgery and rehabilitation.
In the experimental group, the postoperative ROM (133.5±6.3°), Lysholm scores (84.3±5.2), and IKDC scores (4.5±5.1) increased, and the postoperative KT1000 scores (1.6±0.4) dropped. There was a significant difference in the Lysholm scores (P=0.001), the IKDC scores (P=0.001), the KT1000 scores (P=0.001), and the ROM (P=0.000) between preoperative and postoperative values in the experimental group. (Table. 3)
Table 3. Comparison of knee range of motion, Lysholm score, IKDC score and KT-1000 score between pre- and post- operation.
|
Variable
|
Preoperative
|
Final follow-up
|
P
|
Control group
|
Knee range of motion
|
31±3.7°
|
131±4.2°
|
0.000
|
|
Lysholm score
|
36.8±2.5
|
81.5±3.2
|
0.001
|
|
IKDC score
|
53.2±7.1
|
83.6±3.7
|
0.001
|
|
KT-1000 score (mm)
|
9.6±0.4
|
1.7±0.5
|
0.001
|
Experimental group
|
Knee range of motion
|
30±4.5°
|
133.5±6.3°
|
0.000
|
|
Lysholm score
|
37.5±4.1
|
84.3±5.2
|
0.000
|
|
IKDC score
|
54.1±6.2
|
84.5±5.1
|
0.001
|
|
KT-1000 score
|
9.8±0.6
|
1.6±0.4
|
0.001
|
IKDC: International Knee Documentation Committee.
In the control group, the postoperative ROM (131±4.2°), Lysholm scores (81.5±3.2), and IKDC scores (83.6±3.7) also increased, and the KT1000 scores (1.7±0.5) dropped. There was a significant difference in the Lysholm scores (P=0.001), IKDC scores (P=0.001), KT1000 scores (P=0.001), and the ROM (P=0.000) between preoperative and postoperative values in the control group. (Table. 3)
There were no significant differences in knee range of motion, Lysholm score, IKDC score, and KT-1000 score between the two groups at the final follow-up.
We then compared the postoperative ROM, Lysholm scores, IKDC scores, and KT1000 scores between the experimental group and the control group, and found that there were no significant differences in these values between the two groups (P >0.05). (Table. 2)