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Is PLC repair of a peel-off femoral lesion an effective option in a multiligament setting?

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Treatment of posterolateral corner (PLC) injury in the multiligament-injured knee is still controversial. The aim of this study was to investigate the clinical outcome of acute or sub-acute surgical repair of Type 1 and 2 PLC peel-off lesions in a multiligament setting.

Methods

Mini-open direct repair of the PLC was performed in 13 patients. Combined PCL, ACL and MCL injuries were simultaneously managed. Telos valgus and varus stress radiographs at 30° of flexion with 150 N load were used to investigate medial and lateral joint opening. Posterior stress radiograph with 150 N load was used to investigate the function of the PCL. External rotational laxity was assessed with a dial test at 30° of knee flexion, and photographs were taken to measure angles. Anterior displacement was examined using the manual maximum test performed with a KT-1000 arthrometer.

Results

A statistically significant reduction between pre- and postoperative laxity values was achieved for every test. Particularly, lateral joint opening side-to-side difference reduced from 10.3 ± 4.0 to 1.0 ± 3.2 mm and external rotation reduced from 15 ± 8° to 0° ± 6° more than that of the contralateral uninjured knee. The medial joint opening side-to-side difference reduced from 11.5 ± 5.6 to 2.6 ± 2.7 mm in the 7 patients surgically managed for MCL lesion. The anterior tibial displacement side-to-side difference reduced from 14.0 ± 5.0 to 3.0 ± 5.0 mm in the 9 patients surgically managed for ACL lesion. The posterior tibial translation side-to-side difference reduced from 11.1 ± 5.1 to 4.4 ± 3.9 mm in the 11 patients treated for PCL lesion.

Conclusion

The main finding of the current study is that acute repair of Type 1 and 2 PLC peel-off injury proved to be an effective procedure to restore PLC function in a multiligament-injured knee. These data enabled the current literature with an effective treatment option to face such a complex and various scenarios such as multiligament-injured knee.

Level of evidence

IV.

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Authors and Affiliations

  1. Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Bologna, Italy

    Tommaso Bonanzinga

  2. Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Bologna, Italy

    Tommaso Bonanzinga & Cecilia Signorelli

  3. Sports Medicine Service, Beijing Jishuitan Hospital, No. 31, Xinjiekou East Street, Xi Cheng District, Beijing, 10035, China

    Hui Zhang, Guan-yang Song, Jin Zhang & Hua Feng

Authors
  1. Tommaso Bonanzinga
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  2. Hui Zhang
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  3. Guan-yang Song
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  4. Jin Zhang
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  5. Cecilia Signorelli
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  6. Hua Feng
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Corresponding author

Correspondence to Hua Feng.

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Bonanzinga, T., Zhang, H., Song, Gy. et al. Is PLC repair of a peel-off femoral lesion an effective option in a multiligament setting?. Knee Surg Sports Traumatol Arthrosc 23, 2936–2942 (2015). https://doi.org/10.1007/s00167-015-3741-2

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  • DOI: https://doi.org/10.1007/s00167-015-3741-2

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