Outcome of the treatment of chronic isolated and combined posterolateral corner knee injuries with 2- to 6-year follow-up

Arch Orthop Trauma Surg. 2015 Oct;135(10):1363-8. doi: 10.1007/s00402-015-2291-x. Epub 2015 Jul 19.

Abstract

Introduction: Injuries of the posterolateral corner (PLC) of the knee are rare. They are difficult to diagnose and can cause severe disability. This study presents the 20- to 70-month clinical and radiological outcomes of the anatomical reconstruction technique of LaPrade et al.

Materials and methods: Twenty-one patients with chronic PLC injuries underwent anatomical PLC reconstruction. The anatomical locations of the popliteus tendon, fibular collateral ligament, and popliteofibular ligament were reconstructed using a 2-graft technique. The patients were evaluated subjectively with the Tegner, Lysholm, and International Knee Documentation Committee (IKDC) subjective knee scores and objectively with the IKDC objective scores; additionally, varus stress radiographs were taken to evaluate knee stability.

Results: Significant (p < 0.05) improvements were observed in the postoperative Lysholm, IKDC-s, and Tegner scores compared with preoperatively. The IKDC objective subscores (lateral joint opening at 20° of knee extension, external rotation at 30° and 90°, and the reverse pivot-shift test) had improved significantly at the time of the final 40.9 ± 13.7-month follow-up. Lateral compartment opening on the varus stress radiographs had decreased significantly in the postoperative period. However, there was still a significant difference compared with the uninjured knee. There was no significant improvement in the IKDC-s, Lysholm, or Tegner scores between the nine patients with isolated PLC injuries and twelve with multi-ligament injuries.

Conclusions: Significant improvement in the objective knee stability scores and clinical outcomes with anatomical reconstruction showed that this technique can be used to treat patients with chronic PLC injured knees. However, longer-term multicentre studies and studies with larger groups comparing multiple techniques are required to determine the best treatment method for PLC injuries.

Keywords: Knee; Multi-ligament injury; Posterolateral corner; Reconstruction.

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Injuries / surgery*
  • Male
  • Middle Aged
  • Orthopedic Procedures / methods*
  • Posterior Cruciate Ligament / injuries
  • Posterior Cruciate Ligament / surgery*
  • Reconstructive Surgical Procedures / methods*
  • Time Factors
  • Treatment Outcome