Posterolateral reconstruction combined with one-stage tibial valgus osteotomy: Technical considerations and functional results
Carregando...
Citações na Scopus
9
Tipo de produção
article
Data de publicação
2019
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCIENCE BV
Citação
KNEE, v.26, n.2, p.500-507, 2019
Resumo
Background: To report the functional outcomes and complications from reconstructing the knee posterolateral complex (PLC), associated with one-stage opening-wedge tibial valgus osteotomy, and discuss the technical feasibility of this procedure. Methods: Five patients with chronic PLC injuries and varus deviation of the mechanical axis, associated with central pivot injuries or not, underwent medial opening-wedge high tibial osteotomy combined with PLC reconstruction. The lateral collateral ligament, popliteal tendon, and popliteofibular ligament were reconstructed using a single femoral tunnel. Patients were assessed on physical examination, range-of-motion and functional scales, and radiographs. The International Knee Documentation Committee (IKDC) score, Lysholm score, and Knee Injury and Osteoarthritis Outcome score (KOOS) were determined. Results: Five patients were evaluated: four presented with central pivot injury, and one had an isolated PLC injury. The mean time between injury and surgery was 40 +/- 6.5 months (+/- is indicating standard deviation value). Four patients had minimal residual instability on physical examination, with a lateral opening at varus stress of +/- 3 + at 30 degrees flexion. The means of the IKDC score, Lysholm score, and KOOS were 67.8 +/- 9.2, 83.0 +/- 9.3, and 79.2 +/- 5.9, respectively. All patients showed satisfactory consolidation of osteotomy in 2.6 +/- 0.9 months. Conclusions: The results of this series indicate that one-stage PLC ligament reconstruction associated with medial opening-wedge valgus osteotomy is feasible and shows satisfactory functional results with a low rate of complications. A one-stage procedure might be indicated for young patients with high functionality and more pronounced posterolateral instabilities.
Palavras-chave
Knee dislocation, Multiligament injury, Posterolateral complex, Posterolateral corner reconstruction, Single femoral tunnel, Tibial valgus osteotomy
Referências
- Angelini FJ, 2013, ARTHROSC TEC, V2, pE285, DOI 10.1016/j.eats.2013.03.003
- Arthur A, 2007, AM J SPORT MED, V35, P1844, DOI 10.1177/0363546507304717
- Cartwright-Terry M, 2014, ARTHROSCOPY, V30, P811, DOI 10.1016/j.arthro.2014.02.039
- Demange MK, 2011, KNEE, V18, P387, DOI 10.1016/j.knee.2010.11.004
- Helito CP, 2015, INT ORTHOP, V39, P543, DOI 10.1007/s00264-014-2576-7
- Kazimoglu C, 2008, KNEE, V15, P305, DOI 10.1016/j.knee.2008.04.004
- Krukhaug Y, 1998, Knee Surg Sports Traumatol Arthrosc, V6, P21, DOI 10.1007/s001670050067
- Levy BA, 2014, CLIN ORTHOP RELAT R, V472, P2600, DOI 10.1007/s11999-014-3805-5
- Levy BA, 2010, AM J SPORT MED, V38, P804, DOI 10.1177/0363546509352459
- Levy BA, 2009, ARTHROSCOPY, V25, P430, DOI 10.1016/j.arthro.2009.01.008
- Moulton SG, 2016, AM J SPORT MED, V44, P1616, DOI 10.1177/0363546515593950
- Nannaparaju M, 2018, INJURY, V49, P1024, DOI 10.1016/j.injury.2017.10.008
- Noyes FR, 2000, AM J SPORT MED, V28, P282, DOI 10.1177/03635465000280030201
- Noyes FR, 2006, AM J SPORT MED, V34, P1419, DOI 10.1177/0363546506287743
- Sanders TL, 2018, KNEE SURG SPORT TR A, V26, P1258, DOI 10.1007/s00167-017-4631-6
- Savarese E, 2011, J ORTHOP TRAUMATOL, V12, P1, DOI 10.1007/s10195-010-0120-0
- Stannard JP, 2005, AM J SPORT MED, V33, P881, DOI 10.1177/0363546504271208
- Zorzi C, 2013, KNEE SURG SPORT TR A, V21, P1036, DOI 10.1007/s00167-011-1771-y