Background: Posterolateral corner (PLC) injuries of the knee are often overlooked for its complex anatomy, and frequent association with cruciate ligament injuries. Overlooked injuries lead to reconstruction failure of cruciate ligaments, chronic knee pain and early arthritic changes. Many reconstruction methods are described, but the best treatment still remains elusive. In this study, we have treated grade-III PLC injuries by the 'anatomic LaPrade' technique and the 'fibula-based Modified Larson' technique, and evaluated their outcomes. Our hypothesis was that both the groups will have similar improvements after surgery.
Methods: An open-label prospective comparative study was done with a total of 28 patients from August 2013 to July 2019. Patients were treated alternatively by LaPrade or Modified Larson technique using hamstring autografts. Follow-up visits were done at sixth week and subsequently at 3, 6, 12, 18 and 24 months postoperatively. Outcomes were measured by Dial Test, side-to-side difference in lateral opening on varus stress radiographs, Lysholm score and IKDC subjective score.
Results: During analysis, we considered 25 patients only as three patients were lost to follow-up. Both the groups had comparable improvements in rotational stability, lateral opening on varus stress, Lysholm score and IKDC subjective score.
Conclusion: Both LaPrade and Modified Larson technique showed good clinical results in restoring varus and rotational stability of knee in grade-III posterolateral corner injury of the knee.
Level Of Evidence: II (prospective, comparative study).
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8748594 | PMC |
http://dx.doi.org/10.1007/s43465-021-00435-0 | DOI Listing |
JBJS Essent Surg Tech
December 2024
Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut.
Background: For complete disruption of the posterolateral corner (PLC) structures, operative treatment is most commonly advocated, as nonoperative treatment has higher rates of persistent lateral laxity and posttraumatic arthritis. Some studies have shown that acute direct repair results in revision rates upwards of 37% to 40% compared with 6% to 9% for initial reconstruction. In a recent study assessing the outcomes of acute repair of PLC avulsion injuries with 2 to 7 years of follow-up, patients with adequate tissue were shown to have a much lower failure rate than previously documented.
View Article and Find Full Text PDFArthrosc Tech
November 2024
JMVM Sports Injury Centre, Sitaram Bhartia Institute of Science and Research, New Delhi, India.
Collateral injuries are usually found in association with cruciate ligament tears. There are multiple techniques to reconstruct the collateral ligaments using autografts and allografts. Conventionally, interference screws are used to fix the graft on the femur, tibia, and fibula.
View Article and Find Full Text PDFRev Bras Ortop (Sao Paulo)
December 2024
Serviço de Ortopedia, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal.
The original LaPrade technique for anatomic reconstruction of the posterolateral corner of the knee uses two separate allografts. More recently, a modification of this technique, using an adjustable-length suspension device with a cortical button for tibial fixation, allows anatomic reconstruction with a single semitendinosus autograft. This modification is of utmost relevance when sources of allograft are not available for multiligament knee reconstruction.
View Article and Find Full Text PDFOrthop J Sports Med
December 2024
Department of Orthopaedic Surgery, Stanford University, Redwood City, California, USA.
Background: Injury to the posterior vasculature is a potential complication in orthopaedic knee surgery that may be associated with variations in its anatomy, such as the type II-A2 variant, which places the anterior tibial artery (ATA) in closer proximity to the tibia. However, how close surgical instrumentation comes to injuring the ATA is not well described.
Purpose: To determine how the type II-A2 variant of the popliteal vasculature affects proximity of the ATA to instrumentation for orthopaedic knee procedures.
Arch Orthop Trauma Surg
December 2024
Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Purpose: The failure rate following posterolateral corner reconstruction (PLC) remains high. Previous research indicates that in posterior cruciate ligament (PCL) reconstruction the laxity is affected by the tibial slope (TS). However, there is currently no literature evaluating the impact of TS on surgical outcome in combined reconstruction of PLC/PCL.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!