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Effect of Physiological Posterolateral Rotatory Laxity on Early Results of Posterior Cruciate Ligament Reconstruction with Posterolateral Corner Reconstruction

Authors
 Sung-Jae Kim  ;  Sung-Guk Kim  ;  In-Sung Lee  ;  Hee-Don Han  ;  Ihn Hwa Chung  ;  Sung-Hwan Kim  ;  Venkat Gorthi 
Citation
 JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, Vol.95(13) : 1222-1227, 2013 
Journal Title
 JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME 
ISSN
 0021-9355 
Issue Date
2013
MeSH
Adolescent ; Adult ; Arthroscopy ; Female ; Humans ; Joint Instability/physiopathology* ; Joint Instability/rehabilitation ; Joint Instability/surgery ; Knee Injuries/physiopathology* ; Knee Injuries/rehabilitation ; Knee Injuries/surgery* ; Male ; Middle Aged ; Posterior Cruciate Ligament/injuries* ; Posterior Cruciate Ligament/physiopathology ; Posterior Cruciate Ligament/surgery* ; Reconstructive Surgical Procedures/methods* ; Rotation ; Young Adult
Keywords
Adolescent ; Adult ; Arthroscopy ; Female ; Humans ; Joint Instability/physiopathology* ; Joint Instability/rehabilitation ; Joint Instability/surgery ; Knee Injuries/physiopathology* ; Knee Injuries/rehabilitation ; Knee Injuries/surgery* ; Male ; Middle Aged ; Posterior Cruciate Ligament/injuries* ; Posterior Cruciate Ligament/physiopathology ; Posterior Cruciate Ligament/surgery* ; Reconstructive Surgical Procedures/methods* ; Rotation ; Young Adult
Abstract
BACKGROUND: The purpose of this study was to evaluate the influence of physiological posterolateral rotatory laxity on posterior cruciate ligament (PCL) reconstruction in terms of posterior stability and clinical outcomes. METHODS: We retrospectively reviewed the records of sixty-five patients who had undergone arthroscopic PCL reconstruction with simultaneous reconstruction of the posterolateral corner from March 2004 to April 2009. Patients were categorized into three groups according to the amount of tibial external rotation at 90° of knee flexion on the uninjured side: Group 1 (<40°; n = 26), Group 2 (between 40° and 50°; n = 21), and Group 3 (>50°; n = 18). Knee instability was assessed with posterior and varus stress radiographs as well as with the dial test at 30° and 90° of knee flexion. Functional scores were assessed with use of the Lysholm score and the International Knee Documentation Committee (IKDC) score preoperatively and at the time of final follow-up. RESULTS: At the time of follow-up, there was no significant difference among the three groups with regard to the mean side-to-side difference in posterior translation as measured with Telos stress radiography (Group 1: 3.6 ± 1.3 mm, Group 2: 3.3 ± 1.6 mm, and Group 3: 4.3 ± 1.6 mm; p = 0.098). There was also no significant difference among the groups with respect to knee stability as assessed on the varus stress radiographs or with the dial test at 30° and 90° of flexion. Finally, there was no significant difference among the groups with respect to the Lysholm or IKDC functional scores. CONCLUSIONS: This study suggests that the instability of knees that have PCL and posterolateral corner injuries with physiological posterolateral rotatory laxity can be controlled successfully with PCL reconstruction and simultaneous reconstruction of the posterolateral corner. Physiological posterolateral rotatory laxity should not be considered a risk factor for abnormal knee laxity after PCL reconstruction with simultaneous reconstruction of the posterolateral corner.
Full Text
http://www.jbjs.org/article.aspx?doi=10.2106/JBJS.L.00861
DOI
10.2106/JBJS.L.00861
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Guk(김성국)
Kim, Sung Jae(김성재)
Kim, Sung Hwan(김성환) ORCID logo https://orcid.org/0000-0001-5743-6241
Lee, In Sung(이인성)
Han, Hee Don(한희돈)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87706
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