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Posterolateral reconstruction combined with one-stage tibial valgus osteotomy: Technical considerations and functional results.
- Source :
-
The Knee [Knee] 2019 Mar; Vol. 26 (2), pp. 500-507. Date of Electronic Publication: 2019 Jan 08. - Publication Year :
- 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.<br />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.<br />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° 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.<br />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.<br /> (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Subjects :
- Adult
Bone Transplantation
Feasibility Studies
Female
Femur surgery
Humans
Knee Joint surgery
Male
Middle Aged
Osteoarthritis, Knee surgery
Range of Motion, Articular
Recovery of Function
Treatment Outcome
Young Adult
Genu Valgum surgery
Knee Injuries surgery
Osteotomy methods
Posterior Cruciate Ligament injuries
Posterior Cruciate Ligament Reconstruction methods
Tibia surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1873-5800
- Volume :
- 26
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The Knee
- Publication Type :
- Academic Journal
- Accession number :
- 30635152
- Full Text :
- https://doi.org/10.1016/j.knee.2018.12.001