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Outcomes of multiligament knee injury treated with versus without internal brace suture augmentation

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

To compare the postoperative outcomes between Internal Brace (IB) and non-IB patients who underwent surgical management of multiple-ligament knee injuries (MLKI).

Methods

Patients who underwent surgical management of MLKI at two institutions between 2010 and 2020 were identified and offered participation in the study via the collection of postoperative functional outcomes for MLKI; Lysholm Knee score, Multiligament Quality of Life (ML-QOL), Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive testing (CAT), Pain Interference (PI), Physical Function (PF), and Mobility instruments (MI). The postoperative outcomes and reoperation rates were compared between the IB group and non-IB group.

Results

One hundred and twenty-six patients were analyzed; 89 were included in the IB group (31.5% female; age 35.6 ± 1.4 years), and 37 were included in the non-IB group (25.7% female; age 38.8 ± 2.4 years). Mean follow-up time of the entire cohort was 37.9 ± 4.7 months [IB: 21.8 + 1.63; non-IB: 76.4 ± 6.2, p < 0.001). The IB group achieved similar PROMIS CAT [PROMIS Pain (51.8 + 1.1 vs. 52.1 + 1.6, p = 0.8736), Physical Function (46.6 + 1.2 vs. 46.4 + 1.8, p = 0.9168), Mobility (46.0 + 1.0 vs. 43.7 + 1.6, p = 0.2185)], ML-QOL [ML-QOL Physical Impairment (36.6 + 2.5 vs. 43.5 ± 4.2, p = 0.1485), Emotional Impairment (42.5 + 2.9 vs. 48.6 ± 4.6, p = 0.2695), Activity Limitation (34.5 + 2.8 vs. 36.2 ± 4.3, p = 0.7384), Societal Involvement (39.1 + 3.0 vs. 41.7 + 4.2, p = 0.6434)] and Lysholm knee score (64.9 + 2.5 vs. 60.4 + 4.0, p = 0.3397) postoperatively compared the non-IB group, but the differences were not significant.

Conclusion

In this cohort of patients with MLKI treated with versus without IB, outcomes and reoperation rates trended toward favoring IB, but the study was not sufficiently powered to reach statistical significance. Internal bracing could be useful in the management of MLKI. In the future, matched patient cohorts with more patients are warranted to further evaluate the clinical impact of the internal brace in MLKI.

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No funding was received.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Keck School of Medicine of USC, Epstein Family Center for Sports Medicine at Keck Medicine of USC, 1520 San Pablo St #2000, Los Angeles, CA, 90033, USA

    Shane S. Korber, Amir Fathi, Ioanna K. Bolia, Neilen Benvegnu, Tristan W. Juhan, Alexander E. Weber & George F. Hatch

  2. Orthopaedic Surgery, Washington Hospital Center, 110 Irving St NW, Washington, DC, 20010, USA

    Brian J. Panish & Evan H. Argintar

Authors
  1. Shane S. Korber
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  2. Amir Fathi
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  3. Ioanna K. Bolia
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  4. Brian J. Panish
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  5. Neilen Benvegnu
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  6. Tristan W. Juhan
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Corresponding author

Correspondence to Alexander E. Weber.

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Conflict of interest

G.H.: Arthrex (consulting fee), Micromed (hospitality payments). E.A.: Arthrex (consulting fee, speaker fees), KCI USA (consulting fee, speaker fee) Pacira Pharm (consulting fee) Stryker (hospitality payments) Avanos (hospitality payments). All other authors have no competing interests.

Ethical approval

This study was approved by the Institutional Review Boards of the University of Southern California, study #HS-17-00301. This investigation complied with the current laws of the country in which it took place.

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Korber, S.S., Fathi, A., Bolia, I.K. et al. Outcomes of multiligament knee injury treated with versus without internal brace suture augmentation. Eur J Orthop Surg Traumatol 34, 303–309 (2024). https://doi.org/10.1007/s00590-023-03575-1

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