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Satisfactory knee function after single-stage posterolateral corner reconstruction in the multi-ligament injured/dislocated knee using the anatomic single-graft technique

Abstract

Purpose

Increasing importance has been placed on the posterolateral corner (PLC) in maintaining varus and rotational stability of the knee. The goal of this study was to evaluate knee function and clinical stability following a single-graft PLC reconstruction technique and identify factors associated with poor knee function.

Methods

This study identified patients with a multi-ligament knee injury between 2006 and 2013. Patients who received a single-graft fibular collateral ligament and PLC reconstruction with a single-stage surgery during the study period and had a minimum follow-up of 2 years after surgery were included. Functional outcomes were assessed using Lysholm and IKDC scores. Varus and rotational knee laxity and range of motion were assessed using physical examination.

Results

The final study cohort included 61 patients who underwent PLC reconstruction using a single-graft technique. The mean IKDC score was 74.1 (± 22.3) and the mean Lysholm score was 80.3 (± 21.8) at mean follow-up of 3.8 years (range 2–9 years). Mean range of motion at final follow-up measured from 0° to 126° [range flexion: 95–145, range extension: 0–5]. Fifty-eight patients (95%) had grade 0 varus laxity in full knee extension, and 54 patients (88.5%) had grade 0 varus laxity at 30° of knee flexion. Female gender was associated with a lower postoperative IKDC score (p = 0.04).

Conclusion

Surgical treatment of the PLC using a single-graft technique can result in satisfactory knee function and stable physical examination findings at minimum 2 years after surgery. Female gender was predictive of poor knee function after PLC reconstruction. Surgical treatment of PLC injuries should be individualized based on the timing of surgery, specific injured knee structures, and physical examination findings. This study helps validate the use of a single-graft technique for PLC reconstruction and can be used to help counsel patients about expected knee function after surgical treatment of PLC injuries.

Level of evidence IV.

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Correspondence to Bruce A. Levy.

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The authors declare that they have no conflict of interest.

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No external source of funding.

Ethical Approval

Institutional Review Board approval was granted by Mayo Clinic (07-004018).

Informed consent

Informed consent was obtained for all patients in the study.

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Sanders, T.L., Johnson, N.R., Pareek, A. et al. Satisfactory knee function after single-stage posterolateral corner reconstruction in the multi-ligament injured/dislocated knee using the anatomic single-graft technique. Knee Surg Sports Traumatol Arthrosc 26, 1258–1265 (2018). https://doi.org/10.1007/s00167-017-4631-6

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  • DOI: https://doi.org/10.1007/s00167-017-4631-6

Keywords

  • Multi-ligament knee injury
  • Posterolateral corner
  • Knee
  • Knee dislocation