Is PLC repair of a peel-off femoral lesion an effective option in a multiligament setting?

Bonanzinga, Tommaso; Zhang, Hui; Song, Guan yang; Zhang, Jin; Signorelli, Cecilia; Feng, Hao

doi:10.1007/s00167-015-3741-2

Cited by 6 publications

(5 citation statements)

References 32 publications

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“…In a review by Geeslin et al [14], surgical direct repair was recommended in acute avulsed PT injury. In another study by Bonanzinga et al [3] who directly repaired type 1 and 2 PT peel‐off lesion which was defined as bone avulsion of the main structures of the PLC without any mid‐substance stretch injury or fibula‐based injuries [10], reported a significant reduction of SSD of external rotation from 15° ± 8° to 0° ± 6° and improvement of IKDC form evaluation. Consistent with the present study, another review by Kennedy et al [19] reported that isolated or combined treatments for the avulsed PT of the knee are directly repaired or treated with recess procedure in acute stage (< 3 weeks) after injury.…”

Section: Discussionmentioning

confidence: 99%

“…A photograph was taken at both initial and final positions. On the photograph, the bilateral tibial external rotation angle was calculated, and the result of the index knee was compared with the contralateral knee [3]. Positive dial test was defined as side‐to‐side difference (SSD) of ER > 10°.…”

Section: Methodsmentioning

confidence: 99%

“…The goal was to achieve 90° of knee flexion 8 weeks postoperatively and 120° of flexion 12 weeks postoperatively. Partial weight‐bearing was allowed after 12 weeks, and gradually progressed to full weight‐bearing [3, 36].…”

Section: Rehabilitation Protocolmentioning

confidence: 99%

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The clinical outcome of minimally invasive popliteal tendon recess procedure is comparable to arthroscopic popliteal tendon reconstruction in patients with type A posterolateral rotational instability

Feng

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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PurposeTo compare the objective and subjective clinical outcome of minimally invasive popliteal tendon (PT) recess procedure versus arthroscopic PT reconstruction, combined with posterior cruciate ligament reconstruction in patients with Type A posterolateral rotational instability (PLRI). The hypothesis was that the two techniques had comparable clinical outcomes. MethodsBetween 2012 and 2017, patients who were eligible for inclusion in this study if they (1) had Type A PLRI according to Fanelli’s classification with posterior tibial translation > 12 mm on stress radiography and side‐to‐side difference of dial test external rotation > 10°, (2) PT peel‐off lesion or laxity with structural integrity (3) were followed for a minimum of 2 years with examination under anesthesia (EUA) and stress radiograph results. Evaluation included subjective scoring, knee stability examinations and second‐look arthroscopic lateral gutter drive‐through (LGDT) test. Patients who underwent PT recess procedure were designated as Group A, while patients who underwent arthroscopic PT reconstruction were labelled as Group B. The differences between the two groups were analyzed. ResultsA total of 61 eligible patients with a minimum follow‐up time of 2 years were evaluated in the present study. At the final follow‐up, there were no significant inter‐group differences in Lysholm scores (Group A: 69.0 ± 16.5, Group B: 75.8 ± 14.6, ns), Tegner scores [Group A: 2 (1–4), Group B: 3 (1–5), ns], or IKDC subjective scores (Group A: 70.5 ± 13.5, Group B: 71.1 ± 9.1, ns). No significant difference in side‐to‐side difference on posterior stress radiography (Group A: 4.3 ± 3.8 mm, Group B: 4.7 ± 4.6 mm, P = 0.701), dial test result (Group A: 0.9 ± 4.4°, Group B: 1.6 ± 4.9°, ns) or LGDT test positive rate (Group A: 2/34, 5.9%, Group B: 2/27, 7.7%, ns) was observed. ConclusionBoth minimally invasive PT recess procedure and arthroscopic PT reconstruction significantly improved the knee stability and subjective outcome comparing with preoperative value. In a comparison with arthroscopic PT reconstruction, the recess procedure demonstrated comparable subjective and objective clinical outcome. When both PT reconstruction and PT recess procedure are indicated, the minimally invasive and graft‐free recess procedure can be a viable option. Level of evidenceIII.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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The clinical outcome of minimally invasive popliteal tendon recess procedure is comparable to arthroscopic popliteal tendon reconstruction in patients with type A posterolateral rotational instability

Feng

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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“…recommended reconstruction of the PLC structures based on their comparative cohort study [ 31 ]. PLC injury sometimes involves femoral peel-off lesions that can be successfully managed with primary repair [ 32 ]. In this series, repair of the PLC structure demonstrated satisfactory results, apparently because they were all repaired in the acute phase, and recent suture anchors could be used.…”

Section: Discussionmentioning

confidence: 99%

Acute primary repair of extraarticular ligaments and staged surgery in multiple ligament knee injuries

et al. 2020

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Background The purpose of this study is to compare the outcomes of acute primary repair of extraarticular ligaments with staged surgery for acute knee dislocations (KDs) and multiligament knee injuries (MLKIs). Materials and methods Between January 2005 and May 2018, 61 consecutive patients diagnosed with MLKI or KD were referred to or visited our institution. Of these, 31 patients who underwent acute repair of extraarticular ligaments within 3 weeks of injury were included in this study. These patients were retrospectively classified into two groups: those who underwent only primary repair (repair group) and those who underwent staged reconstructive surgery (staged group). Follow-up examination included range of motion (ROM), knee joint stability (Lachman test, posterior drawer test, and varus and valgus stress test), Lysholm knee score, Tegner activity scale, and Knee Injury and Osteoarthritis and Outcome Score (KOOS). Results Twelve of the 31 patients did not need or desire further surgery and were included in the repair group. No significant difference was observed in demographic data between the repair and staged groups. Although staged surgery decreased positive posterior drawer test results, no significant difference was observed between the two groups regarding ROM, other knee joint stability tests, Lysholm scores, Tegner scale, or KOOS. Conclusions In this series, all patients returned to their activities of daily living and preinjury occupation levels. Acute primary repair of extraarticular ligaments provides essential knee stability without varus/valgus instability and may reduce the need for subsequent cruciate ligament reconstruction. Level of evidence Level IV, retrospective observational study.

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“…Bonanzinga ve ark., çoklu bağ yaralanması olan 13 olguda AÇB "peel-off" yaralanmasının primer tamiri ile başarılı sonuçlar bildirmişlerdir. [57] Bağın primer onarımı propriyoseptif özelliklerini korurken, aynı zamanda çoklu bağ cerrahisinde zaten kısıtlı olan greft kaynaklarının da ekonomik olarak kullanımına imkân sağlar. ÖÇB peel-off yaralanması kemik avulsiyonlara göre çok daha nadirdir.…”

Section: Aci̇l Tedavi̇unclassified

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Mermerkaya¹,

Polat²,

Tanrıöver³

et al. 2019

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Is PLC repair of a peel-off femoral lesion an effective option in a multiligament setting?

Abstract: IV.

Cited by 6 publications

References 32 publications

The clinical outcome of minimally invasive popliteal tendon recess procedure is comparable to arthroscopic popliteal tendon reconstruction in patients with type A posterolateral rotational instability

The clinical outcome of minimally invasive popliteal tendon recess procedure is comparable to arthroscopic popliteal tendon reconstruction in patients with type A posterolateral rotational instability

Acute primary repair of extraarticular ligaments and staged surgery in multiple ligament knee injuries

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