TY - JOUR
T1 - Repair Versus Reconstruction of the Fibular Collateral Ligament and Posterolateral Corner in the Multiligament-Injured Knee
AU - Levy, Bruce A.
AU - Dajani, Khaled A.
AU - Morgan, Joseph A.
AU - Shah, Jay P.
AU - Dahm, DIane L.
AU - Stuart, Michael J.
N1 - Publisher Copyright:
© 2010 The Author(s).
PY - 2010/4/1
Y1 - 2010/4/1
N2 - Background: Treatment of the multiligament-injured knee remains controversial. Purpose: To compare clinical and functional outcomes of a consecutive series of multiligament-injured knees that underwent repair of the fibular collateral ligament (FCL) and posterolateral corner (PLC), followed by delayed cruciate ligament reconstructions, with those that had single-stage multiligament reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: Patients with multiligament knee injury treated by a single surgeon were identified in our prospective database. Between February 2004 and May 2005, patients underwent repair of medial- and lateral-sided injuries, followed by delayed cruciate ligament reconstructions. Between May 2005 and February 2007, patients underwent single-stage multiligament knee reconstruction. All patients followed a standard rehabilitation protocol. Inclusion criteria were minimum 2-year follow-up and multiligament knee injury including the FCL/PLC. International Knee Documentation Committee subjective and Lysholm scores and objective clinical data were documented. Results: We identified 45 knees (42 patients); 17 knees (14 patients) were excluded, leaving 28 knees (28 patients) in the study. The repair/staged group (10 knees in 10 patients) had a mean follow-up of 34 months (range, 24-49 months). The reconstruction group (18 knees in 18 patients) had a mean follow-up of 28 months (range, 24-41 months). Four of the 10 FCL/PLC repairs (40%) and 1 of the 18 FCL/PLC reconstructions (6%) failed (P =.04). After revision reconstructions, there were no statistically significant differences between mean International Knee Documentation Committee subjective scores (79 vs. 77, P =.92) and mean Lysholm scores (85 vs 88, P =.92). Regression analysis showed no effect on failure based on age, sex, injury mechanism, time to surgery, interval between stages, total number of ligaments injured, or location of tear. Conclusion: Our series demonstrated a statistically significant higher rate of failure for repair compared with reconstruction of the FCL/PLC. Reconstruction of the FCL/PLC structures is a more reliable option than repair alone in the setting of a multiligament knee injury.
AB - Background: Treatment of the multiligament-injured knee remains controversial. Purpose: To compare clinical and functional outcomes of a consecutive series of multiligament-injured knees that underwent repair of the fibular collateral ligament (FCL) and posterolateral corner (PLC), followed by delayed cruciate ligament reconstructions, with those that had single-stage multiligament reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: Patients with multiligament knee injury treated by a single surgeon were identified in our prospective database. Between February 2004 and May 2005, patients underwent repair of medial- and lateral-sided injuries, followed by delayed cruciate ligament reconstructions. Between May 2005 and February 2007, patients underwent single-stage multiligament knee reconstruction. All patients followed a standard rehabilitation protocol. Inclusion criteria were minimum 2-year follow-up and multiligament knee injury including the FCL/PLC. International Knee Documentation Committee subjective and Lysholm scores and objective clinical data were documented. Results: We identified 45 knees (42 patients); 17 knees (14 patients) were excluded, leaving 28 knees (28 patients) in the study. The repair/staged group (10 knees in 10 patients) had a mean follow-up of 34 months (range, 24-49 months). The reconstruction group (18 knees in 18 patients) had a mean follow-up of 28 months (range, 24-41 months). Four of the 10 FCL/PLC repairs (40%) and 1 of the 18 FCL/PLC reconstructions (6%) failed (P =.04). After revision reconstructions, there were no statistically significant differences between mean International Knee Documentation Committee subjective scores (79 vs. 77, P =.92) and mean Lysholm scores (85 vs 88, P =.92). Regression analysis showed no effect on failure based on age, sex, injury mechanism, time to surgery, interval between stages, total number of ligaments injured, or location of tear. Conclusion: Our series demonstrated a statistically significant higher rate of failure for repair compared with reconstruction of the FCL/PLC. Reconstruction of the FCL/PLC structures is a more reliable option than repair alone in the setting of a multiligament knee injury.
KW - fibular collateral ligament
KW - knee dislocation
KW - multiligament knee reconstruction
KW - posterolateral corner
UR - http://www.scopus.com/inward/record.url?scp=77953307872&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77953307872&partnerID=8YFLogxK
U2 - 10.1177/0363546509352459
DO - 10.1177/0363546509352459
M3 - Article
C2 - 20118498
AN - SCOPUS:77953307872
SN - 0363-5465
VL - 38
SP - 804
EP - 809
JO - American Journal of Sports Medicine
JF - American Journal of Sports Medicine
IS - 4
ER -