Journal article
No Difference Between Posterolateral Corner Repair and Reconstruction With Concurrent ACL Surgery Results From a Prospective Multicenter Cohort
Orthopaedic journal of sports medicine, Vol.7(7), pp.2325967119861062-2325967119861062
07/30/2019
DOI: 10.1177/2325967119861062
PMCID: PMC6685111
PMID: 31431898
Abstract
Background: Injuries to the posterolateral corner (PLC) may occur concurrently with anterior cruciate ligament (ACL) injury.
Purpose/Hypothesis: This study evaluated the outcomes of patients who underwent operative management of PLC injuries concurrently with ACL reconstruction in a prospective multicenter cohort. We hypothesized that there would be no differences in outcomes between patients who were treated with PLC repair and PLC reconstruction.
Study Design: Cohort study; Level of evidence, 3.
Methods: Patients undergoing ACL reconstruction were enrolled into a prospective longitudinal multicenter cohort between 2002 and 2008. Those with complete 6-year follow-up data (patient-reported outcomes and subsequent surgery information) were identified. Excluded from the study were patients with posterior cruciate ligament injuries. Patients who underwent PLC repair were compared with those who underwent PLC reconstruction with regard to interval from injury to surgery, need for revision surgery, and long-term outcomes at 6 years.
Results: During the identified time frame, 3026 identified patients underwent primary ACL reconstruction; 34 (1.1%) also underwent concurrent PLC surgery (15 repairs, 19 reconstructions [18 allografts, 1 autograft]). With the numbers available, we did not detect significant differences between groups regarding the rate of meniscal or chondral injuries. Median time to PLC reconstruction was 121 days as compared with 19 days for concurrent ACL reconstruction and PLC repair (P = .01). There were no between-group differences in Marx activity scores prior to surgery (P = .4). At 6-year follow-up, there were no between-group differences in Knee injury and Osteoarthritis Outcome Score (P = .36-.83) or International Knee Documentation Committee score (P .84); however, patients treated with PLC reconstructions had lower Marx activity scores (4.1 vs 9.4; P = .02). There was 1 ACL revision in the PLC reconstruction group, and 1 of the PLC repairs was revised to a reconstruction during the follow-up period.
Conclusion: Good outcomes were achieved at 6-year follow-up with both repair and reconstruction of PLC injuries treated concurrently with ACL reconstruction. The PLC reconstruction group had lower activity levels 6 years after surgery. The present data suggest that, for appropriately selected patients undergoing acute surgical treatment of combined ACL and PLC injuries, PCL repair can achieve good long-term outcomes.
Details
- Title: Subtitle
- No Difference Between Posterolateral Corner Repair and Reconstruction With Concurrent ACL Surgery Results From a Prospective Multicenter Cohort
- Creators
- Robert W. Westermann - University of IowaRobert G. Marx - Hospital for Special SurgeryKurt P. Spindler - Cleveland ClinicLaura J. Huston - Vanderbilt University Medical CenterAnnunziato Amendola - University of IowaJack T. Andrish - University of IowaRobert H. Brophy - University of Iowa Hospitals and ClinicsWarren R. Dunn - University of IowaDavid C. Flanigan - University of IowaMorgan H. Jones - University of IowaChristopher C. Kaeding - University of IowaMatthew J. Matava - University of IowaEric C. McCarty - University of IowaRichard D. Parker - University of IowaEmily K. Reinke - University of IowaArmando F. Vidal - University of IowaMichelle L. Wolcott - University of IowaBrian R. Wolf - University of Iowa Hospitals and ClinicsMOON Knee Group
- Resource Type
- Journal article
- Publication Details
- Orthopaedic journal of sports medicine, Vol.7(7), pp.2325967119861062-2325967119861062
- DOI
- 10.1177/2325967119861062
- PMID
- 31431898
- PMCID
- PMC6685111
- NLM abbreviation
- Orthop J Sports Med
- ISSN
- 2325-9671
- eISSN
- 2325-9671
- Publisher
- Sage
- Number of pages
- 5
- Grant note
- DonJoy Smith Nephew R01AR053684 / National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS) R01AR053684 / NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS)
- Language
- English
- Date published
- 07/30/2019
- Academic Unit
- Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science; Athletic Training Program
- Record Identifier
- 9984295053802771
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