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https://observatorio.fm.usp.br/handle/OPI/32503
Title: | Posterolateral reconstruction combined with one-stage tibial valgus osteotomy: Technical considerations and functional results |
Authors: | HELITO, Camilo Partezani; SOBRADO, Marcel Faraco; GIGLIO, Pedro Nogueira; BONADIO, Marcelo Batista; DEMANGE, Marco Kawamura; PECORA, Jose Ricardo; CAMANHO, Gilberto Luis; ANGELINI, Fabio Janson |
Citation: | KNEE, v.26, n.2, p.500-507, 2019 |
Abstract: | 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. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MOT Artigos e Materiais de Revistas Científicas - HC/IOT Artigos e Materiais de Revistas Científicas - LIM/41 |
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