A comparative study between laprade and Larson’s technique for posterolateral corner [PLC] Injury of knee

Benguluri, Ramesh; Reddy, C. R. Vijay Bharath; Venkatesh, Balasubramanian; Sunder, C Sham

doi:10.22271/ortho.2021.v7.i2c.2628

Cited by 1 publication

(16 citation statements)

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“…The fixation sequences of all of the Larson procedures (including the modified Larson procedures) were similar, with the graft being fixed first to the fibular tunnels followed by the femoral tunnel. 4,37,45,51 However, the position of the knee upon femoral fixation varied among these studies. One study fixed the graft in complete extension, 4 1 study in 20° of knee flexion, 45 and 2 studies in 30° of knee flexion.…”

Section: Resultsmentioning

confidence: 99%

“…For the tibiofibular-based reconstructions, the majority of studies ensured the femoral tunnels arose from the LCL and PT attachment sites and that the fibular tunnels were oriented to closely recreate the anatomic attachment of the native LCL and PFL. 4,37,45,47,51 Four studies provided an adequate description of the tibial tunnel orientation, arising from a point just distal and medial from the Gerdy tubercle to the popliteal sulcus of the tibia. 37,45,47,51…”

Section: Resultsmentioning

confidence: 99%

“…45,51 Last, all of the grafts were fixed to the tibial tunnel of the PT between 60° and 70° of knee flexion. 4,37,45,47,51…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the MCMS of the 6 included studies (mean score, 56.7), 2 studies achieved good scores, 37,47 2 studies achieved fair scores, 45,51 and 2 studies achieved poor scores. 4,20 The overall quality of the studies was fair. The characteristics of these studies are described in Table 2.…”

Section: Methodological Quality Of Included Studiesmentioning

confidence: 99%

“…45,51 Last, all of the grafts were fixed to the tibial tunnel of the PT between 60°and 70°of knee flexion. 4,37,45,47,51 Rehabilitation differed among studies, with full weightbearing starting as early as 6 weeks in 2 studies, 47,51 8 weeks in 1 study, 45 and 3 months in 1 study. 37…”

Section: Methodological Quality Of Included Studiesmentioning

confidence: 99%

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Fibular- Versus Tibiofibular-Based Reconstruction of the Posterolateral Corner of the Knee: A Systematic Review and Meta-analysis

et al. 2023

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Background: Fibular- and tibiofibular-based reconstructions are the gold standard treatment for posterolateral corner (PLC) injuries of the knee. Despite comparable outcomes in biomechanical studies, clinical results comparing these constructs remain elusive with no consensus reached regarding the best treatment option. Purpose: To perform a systematic review and meta-analysis to compare fibular- and tibiofibular-based techniques for posterolateral corner reconstruction. We aimed to identify whether any differences existed between the 2 techniques in terms of clinical outcomes and rotational and varus stability. Study Design: Meta-analysis; Level of evidence, 4. Methods: The Cochrane Controlled Register of Trials, PubMed, Medline, and Embase were used to perform a systematic review and meta-analysis using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria with the following search terms (“posterolateral corner” OR “fibular collateral ligament” OR “lateral collateral ligament” OR “popliteus tendon” OR “popliteofibular ligament”) AND (“reconstruction” OR “LaPrade” OR “Larson” OR “Arciero”). Data pertaining to all patient-reported outcome measures (PROMs), postoperative complications, and valgus and rotational stability were extracted from each study. The pooled outcome data were analyzed by random- and fixed-effects models. Results: After abstract and full-text screening, 6 clinical studies were included. In total, there were 183 patients, of which 90 received fibular-based and 93 tibiofibular-based reconstruction. The majority of studies used similar surgical techniques regarding tunnel orientation, attachment sites, and graft fixation sequence. There were no differences between the groups in terms of PROMs and subjective knee scores at a mean of 20.3 months. The techniques were equally effective in restoring varus and rotational stability. Subgroup analysis revealed that the stability of a posterior cruciate ligament reconstruction postoperatively was not affected by either construct. Conclusion: Both constructs had comparable clinical outcomes and were equally effective in restoring varus and rotational stability for PLC knee injuries. The fibular-based technique may offer advantages in view of being less technically demanding and invasive and requiring fewer grafts with a quicker operative time. However, higher quality studies are required to reinforce or refute such conclusions, as the majority of studies in this review were poor to fair quality.

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