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Clinical comparison of conventional and remnant-preserving transtibial single-bundle posterior cruciate ligament reconstruction combined with posterolateral corner reconstruction

 Sung-Jae Kim  ;  Sung-Hwan Kim  ;  Yong-Min Chun  ;  Byoung-Yoon Hwang  ;  Duck-Hyun Choi  ;  Ji-Young Yoon 
 AMERICAN JOURNAL OF SPORTS MEDICINE, Vol.40(3) : 640-649, 2012 
Journal Title
Issue Date
Adolescent ; Adult ; Arthroscopy/methods ; Female ; Humans ; Joint Instability/diagnostic imaging ; Joint Instability/surgery ; Knee Injuries/surgery ; Male ; Middle Aged ; Orthopedic Procedures/methods* ; Posterior Cruciate Ligament/diagnostic imaging ; Posterior Cruciate Ligament/surgery* ; Radiography ; Range of Motion, Articular ; Recovery of Function ; Retrospective Studies ; Tibia/diagnostic imaging ; Tibia/surgery* ; Treatment Outcome ; Young Adult
knee ; posterior cruciate ligament ; reconstruction ; remnant preservation
BACKGROUND: Despite persistent continuity of the attenuated posterior cruciate ligament (PCL) in most PCL insufficient knees, few reconstruction techniques that preserve the PCL remnant have been presented. Furthermore, data regarding the clinical outcomes of these approaches are even more limited, and the clinical validity of remnant preservation has not yet been established.

PURPOSE: To compare the clinical outcomes of transtibial PCL reconstructions that incorporate remnant preservation with conventional techniques (in which remnant preservation is not performed).

STUDY DESIGN: Cohort study; Level of evidence 3.

METHODS: The authors retrospectively evaluated 53 cases of PCL reconstruction with simultaneous posterolateral corner reconstruction. Of these, 23 were performed with a conventional approach without remnant preservation (group C), and 30 incorporated a remnant-preserving technique (group R). In all cases, the minimum follow-up period was 24 months. Each patient was evaluated using the following variables: Lysholm knee score, Tegner activity scale, return to activity, International Knee Documentation Committee (IKDC) knee score and grade, and degree of posterior laxity on stress radiograph.

RESULTS: The mean side-to-side differences in posterior tibial translation, Lysholm knee score, return to activity, and objective IKDC grade were similar between group C (4.4 ± 3.0 mm; 82.6 ± 11.0; 21.7%; A and B: 73.9%) and group R (4.1 ± 3.4 mm; 84.1 ± 10.7; 26.7%; A and B: 83.3%; P = .761, .611, .679, .755). However, the final Tegner activity scale, near-return to activity, and subjective IKDC score differed significantly between group C (3.5 ± 0.8; 43.5%; 64.5 ± 8.8) and group R (4.3 ± 1.1; 73.3%; 70.6 ± 7.9; P = .007, .028, .012).

CONCLUSION: Techniques combining remnant-preserving transtibial single-bundle PCL reconstruction with posterolateral corner reconstruction resulted in somewhat better activity-related outcomes compared with those of approaches without remnant preservation. However, incorporation of remnant preservation does not appear to provide increased posterior stability or result in clinically superior outcomes versus those of techniques without remnant preservation.
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1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Jae(김성재)
Kim, Sung Hwan(김성환) ORCID logo https://orcid.org/0000-0001-5743-6241
Chun, Yong Min(천용민) ORCID logo https://orcid.org/0000-0002-8147-6136
Choi, Duck Hyun(최덕현)
Hwang, Byoung Yoon(황병윤)
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