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Archives of Orthopaedic and Traumatic Surgery
Article . 2024 . Peer-reviewed
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Combined PCL and anatomic posterolateral corner reconstruction: A tibial slope under 8 degrees and a persisting dorsal instability of 4 mm or more have a negative effect on the clinical outcome

Authors: H. Fahlbusch; S. Weiß; A. Korthaus; R. Akoto; M. Krause; K. H. Frosch;

Combined PCL and anatomic posterolateral corner reconstruction: A tibial slope under 8 degrees and a persisting dorsal instability of 4 mm or more have a negative effect on the clinical outcome

Abstract

Abstract Purpose The failure rate following posterolateral corner reconstruction (PLC) remains high. Previous research indicates that in posterior cruciate ligament (PCL) reconstruction the laxity is affected by the tibial slope (TS). However, there is currently no literature evaluating the impact of TS on surgical outcome in combined reconstruction of PLC/PCL. Methods This study analyzed 47 patients in a retrospective cohort study who underwent PCL and anatomical PLC reconstruction according to techniques described by Arciero or LaPrade. TS was measured, and patients were divided into two groups: Group A (n = 16) with TS < 8° and Group B (n = 31) with TS ≥ 8°. After a minimum follow-up of 12 months, the side-to-side difference (SSD) of posterior tibial translation (PTT) was assessed using instrumented stability testing (Rolimeter), and various patient-reported outcome measures (IKDC, Lysholm) were collected and compared. Results At a mean follow-up of 17.7 ± 4.7 months, group A exhibited a higher SSD of PTT (A 3.9 mm ± 2.1 vs. B: 2.8 mm ± 1.5; p < 0.05). A negative correlation was observed between SSD of PTT and both TS (r = − 0.43; R 2 = 0.18; p < 0.01) and the Lysholm Score (r = − 0.41; R 2 = 0.17; p < 0.01) in the overall cohort. Subgroup analysis revealed a higher Lysholm Score in patients with a postoperative SSD of PTT less than 4 mm (85.7 ± 10.1 vs. 79.2 ± 6.6; p = 0.0006). Conclusion In combined PCL and anatomic PLC reconstruction a TS < 8° results in elevated SSD of PTT. A flattened TS is linked to higher remaining SSD of PTT, while lower SSD of PTT is associated with improved clinical outcomes. Level of evidence Retrospective Cohort Study, IV.

Keywords

Male, Adult, Joint Instability, Tibia, Knee Joint, Research, Posterior Cruciate Ligament Reconstruction, Middle Aged, Young Adult, Treatment Outcome, Humans, Female, Posterior Cruciate Ligament, Female [MeSH] ; Tibia/surgery [MeSH] ; Posterolateral corner ; Adult [MeSH] ; Humans [MeSH] ; Posterior cruciate ligament ; Treatment Outcome [MeSH] ; Knee Joint/surgery [MeSH] ; PCL ; Retrospective Studies [MeSH] ; Middle Aged [MeSH] ; Research ; PLC ; Posterior slope ; Male [MeSH] ; Posterior Cruciate Ligament/surgery [MeSH] ; Posterior tibial translation ; Young Adult [MeSH] ; Joint Instability/surgery [MeSH] ; Reconstruction ; Posterior Cruciate Ligament Reconstruction/methods [MeSH], Retrospective Studies

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
2
Top 10%
Average
Average
Green
hybrid