Anzeige
Erschienen in:
01.09.2014 | Knee
Rotational profile alterations after anatomic posterolateral corner reconstructions in multiligament injured knees
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 9/2014
Einloggen, um Zugang zu erhaltenAbstract
Purpose
Injuries of the posterolateral corner (PLC) are rare and severe knee injuries, resulting in posterolateral rotatory instability and an increase in external rotation. Surgical reconstruction techniques reproducing the normal anatomy showed promising results. In vivo evaluations of static rotational knee laxity at 30° of knee flexion have not been reported so far. The purpose of this study was to evaluate static rotational knee laxity after anatomic PLC reconstructions.
Methods
This is a retrospective clinical cohort study. Twenty patients with PLC reconstructions with an average follow-up time of 39 ± 22 months and no history of knee trauma or surgery of the contralateral knee were included in the study. They underwent a routine clinical examination and static rotational laxity measurements at 30° of knee flexion in the prone position. Side-to-side differences were recorded and compared to a group of matched controls.
Results
The postoperative IKDC score was graded A for 8 patients, B for 16, C for 6 and D for one patient. The primary goal of the surgical procedure which consists in reducing excessive external tibiofemoral rotation could be reached in 18 of the 20 patients (90 %). Anatomic PLC reconstructions yielded a comparable rotational profile in operated and healthy knees in 7 patients (35 %). Thirteen patients (65 %) presented a significantly altered rotational profile in comparison with a healthy control group. Unexpected increases in internal rotation were found in 8 patients (40 %).
Conclusion
Anatomic PLC reconstructions reduced excessive external tibiofemoral rotation in a vast majority of patients. Static rotational laxity measurements allowed for a determination of the patients’ individual rotational profile after PLC reconstructions. This profile was normalised in only one-third of the patients. The understanding of this finding needs further investigation as well as the clinical impact of rotational profile alterations on knee function.
Level of evidence
Diagnostic studies, Level III.