TY - JOUR
T1 - Non-anatomical reconstruction of chronic posterolateral corner knee injuries show failure rates from 0% to 36% versus 4.3% to 24.2% for anatomic reconstruction techniques
T2 - An updated systematic review reflecting the 2019 expert consensus statement
AU - Jackson, Garrett R.
AU - Mameri, Enzo S.
AU - Condon, Joshua
AU - DeWald, Daniel
AU - Batra, Anjay
AU - Salazar, Luis M.
AU - Familiari, Filippo
AU - Matava, Matthew
AU - Knapik, Derrick M.
AU - Verma, Nikhil N.
AU - LaPrade, Robert F.
AU - Chahla, Jorge
N1 - Publisher Copyright:
© 2023 The Author(s)
PY - 2024/6
Y1 - 2024/6
N2 - Objective: To review and update the literature regarding outcomes following surgical management of chronic, grade III posterolateral corner (PLC) injuries, with an emphasis on estimating failure rates based upon objective parameters in light of the 2019 expert consensus, while secondarily comparing the failure rates of anatomic versus non-anatomic reconstruction techniques. Methods: A literature search was performed using the PubMed, Embase, MEDLINE, and Cochrane Library databases. Inclusion criteria consisted of level I-IV human clinical studies reporting subjective and objective outcomes in patients following surgical management for chronic (>6 weeks from injury) grade III PLC injuries, with a minimum two-year follow-up. The criterion for objective surgical failure was based on post-operative varus stress radiographs and defined as a side-to-side difference of 3 mm or more of lateral gapping. Results: A total of six studies, consisting of 10 separate cohorts encompassing a total of 230 patients, were identified. PLC reconstruction was performed in all cohorts, with 80 % (n = 8/10) of these cohorts utilising an anatomic reconstruction technique. A failure rate ranging from 4.3 % to 36 % was found. Subgroup analysis revealed a failure rate of 4.3 %–24.2 % for anatomic reconstruction techniques, whereas a 0 %–36 % failure rate was found for non-anatomic reconstruction. Arthrofibrosis was the most common complication (range, 0 %–12.1 %) following surgery. 0 %–8 % of patients required revision PLC surgery. Conclusion: PLC reconstruction yields a wide variability in failure rates according to the side-to-side difference of 3 mm or more of lateral gapping on post-operative varus stress radiographs, with low revision rates following anatomic and non-anatomic reconstruction techniques. Level of evidence: IV; Systematic Review of Level III and IV studies.
AB - Objective: To review and update the literature regarding outcomes following surgical management of chronic, grade III posterolateral corner (PLC) injuries, with an emphasis on estimating failure rates based upon objective parameters in light of the 2019 expert consensus, while secondarily comparing the failure rates of anatomic versus non-anatomic reconstruction techniques. Methods: A literature search was performed using the PubMed, Embase, MEDLINE, and Cochrane Library databases. Inclusion criteria consisted of level I-IV human clinical studies reporting subjective and objective outcomes in patients following surgical management for chronic (>6 weeks from injury) grade III PLC injuries, with a minimum two-year follow-up. The criterion for objective surgical failure was based on post-operative varus stress radiographs and defined as a side-to-side difference of 3 mm or more of lateral gapping. Results: A total of six studies, consisting of 10 separate cohorts encompassing a total of 230 patients, were identified. PLC reconstruction was performed in all cohorts, with 80 % (n = 8/10) of these cohorts utilising an anatomic reconstruction technique. A failure rate ranging from 4.3 % to 36 % was found. Subgroup analysis revealed a failure rate of 4.3 %–24.2 % for anatomic reconstruction techniques, whereas a 0 %–36 % failure rate was found for non-anatomic reconstruction. Arthrofibrosis was the most common complication (range, 0 %–12.1 %) following surgery. 0 %–8 % of patients required revision PLC surgery. Conclusion: PLC reconstruction yields a wide variability in failure rates according to the side-to-side difference of 3 mm or more of lateral gapping on post-operative varus stress radiographs, with low revision rates following anatomic and non-anatomic reconstruction techniques. Level of evidence: IV; Systematic Review of Level III and IV studies.
KW - Anatomic reconstruction
KW - Fibular collateral ligament
KW - Knee
KW - Popliteofibular ligament
KW - Popliteus tendon
KW - Posterolateral corner
UR - http://www.scopus.com/inward/record.url?scp=85180353292&partnerID=8YFLogxK
U2 - 10.1016/j.jisako.2023.11.010
DO - 10.1016/j.jisako.2023.11.010
M3 - Review article
C2 - 38042407
AN - SCOPUS:85180353292
SN - 2059-7754
VL - 9
SP - 362
EP - 370
JO - Journal of ISAKOS
JF - Journal of ISAKOS
IS - 3
ER -