Institutional members access full text with Ovid®

Share this article on:

Effect of Physiological Posterolateral Rotatory Laxity on Early Results of Posterior Cruciate Ligament Reconstruction with Posterolateral Corner Reconstruction

Kim, Sung-Jae MD; Kim, Sung-Guk MD; Lee, In-Sung MD; Han, Hee-Don MD; Chung, Ihn Hwa MD; Kim, Sung-Hwan MD; Gorthi, Venkat MS

Journal of Bone & Joint Surgery - American Volume: 3 July 2013 - Volume 95 - Issue 13 - p 1222–1227
doi: 10.2106/JBJS.L.00861
Scientific Articles
Supplementary Content
Disclosures
Disclosures

Background: The purpose of this study was to evaluate the influence of physiological posterolateral rotatory laxity on posterior cruciate ligament (PCL) reconstruction in terms of posterior stability and clinical outcomes.

Methods: We retrospectively reviewed the records of sixty-five patients who had undergone arthroscopic PCL reconstruction with simultaneous reconstruction of the posterolateral corner from March 2004 to April 2009. Patients were categorized into three groups according to the amount of tibial external rotation at 90° of knee flexion on the uninjured side: Group 1 (<40°; n = 26), Group 2 (between 40° and 50°; n = 21), and Group 3 (>50°; n = 18). Knee instability was assessed with posterior and varus stress radiographs as well as with the dial test at 30° and 90° of knee flexion. Functional scores were assessed with use of the Lysholm score and the International Knee Documentation Committee (IKDC) score preoperatively and at the time of final follow-up.

Results: At the time of follow-up, there was no significant difference among the three groups with regard to the mean side-to-side difference in posterior translation as measured with Telos stress radiography (Group 1: 3.6 ± 1.3 mm, Group 2: 3.3 ± 1.6 mm, and Group 3: 4.3 ± 1.6 mm; p = 0.098). There was also no significant difference among the groups with respect to knee stability as assessed on the varus stress radiographs or with the dial test at 30° and 90° of flexion. Finally, there was no significant difference among the groups with respect to the Lysholm or IKDC functional scores.

Conclusions: This study suggests that the instability of knees that have PCL and posterolateral corner injuries with physiological posterolateral rotatory laxity can be controlled successfully with PCL reconstruction and simultaneous reconstruction of the posterolateral corner. Physiological posterolateral rotatory laxity should not be considered a risk factor for abnormal knee laxity after PCL reconstruction with simultaneous reconstruction of the posterolateral corner.

Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

1Department of Orthopaedic Surgery and the Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea. E-mail address for S.-G. Kim: p10001@hanmail.net

Copyright 2013 by The Journal of Bone and Joint Surgery, Incorporated
You currently do not have access to this article

To access this article: