Document Detail


Clinical Comparison of Conventional and Remnant-Preserving Transtibial Single-Bundle Posterior Cruciate Ligament Reconstruction Combined With Posterolateral Corner Reconstruction.
MedLine Citation:
PMID:  22109544     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Despite persistent continuity of the attenuated posterior cruciate ligament (PCL) in most PCL insufficient knees, few reconstruction techniques that preserve the PCL remnant have been presented. Furthermore, data regarding the clinical outcomes of these approaches are even more limited, and the clinical validity of remnant preservation has not yet been established. PURPOSE: To compare the clinical outcomes of transtibial PCL reconstructions that incorporate remnant preservation with conventional techniques (in which remnant preservation is not performed). STUDY DESIGN: Cohort study; Level of evidence 3. Methods: The authors retrospectively evaluated 53 cases of PCL reconstruction with simultaneous posterolateral corner reconstruction. Of these, 23 were performed with a conventional approach without remnant preservation (group C), and 30 incorporated a remnant-preserving technique (group R). In all cases, the minimum follow-up period was 24 months. Each patient was evaluated using the following variables: Lysholm knee score, Tegner activity scale, return to activity, International Knee Documentation Committee (IKDC) knee score and grade, and degree of posterior laxity on stress radiograph. Results: The mean side-to-side differences in posterior tibial translation, Lysholm knee score, return to activity, and objective IKDC grade were similar between group C (4.4 ± 3.0 mm; 82.6 ± 11.0; 21.7%; A and B: 73.9%) and group R (4.1 ± 3.4 mm; 84.1 ± 10.7; 26.7%; A and B: 83.3%; P = .761, .611, .679, .755). However, the final Tegner activity scale, near-return to activity, and subjective IKDC score differed significantly between group C (3.5 ± 0.8; 43.5%; 64.5 ± 8.8) and group R (4.3 ± 1.1; 73.3%; 70.6 ± 7.9; P = .007, .028, .012). Conclusion: Techniques combining remnant-preserving transtibial single-bundle PCL reconstruction with posterolateral corner reconstruction resulted in somewhat better activity-related outcomes compared with those of approaches without remnant preservation. However, incorporation of remnant preservation does not appear to provide increased posterior stability or result in clinically superior outcomes versus those of techniques without remnant preservation.
Authors:
Sung-Jae Kim; Sung-Hwan Kim; Yong-Min Chun; Byoung-Yoon Hwang; Duck-Hyun Choi; Ji-Young Yoon
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-22
Journal Detail:
Title:  The American journal of sports medicine     Volume:  -     ISSN:  1552-3365     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609541     Medline TA:  Am J Sports Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Korea.
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