A Wajsfisz1, X Bajard2, S Plaweski3, P Djian4, G Demey5, R Limozin6, V Bousquet7, G Rocheconcar8, M-L Louis9, J Arndt10, M Azar8, B Sonnery-Cottet11, P Boisrenoult12. 1. Clinique Drouot, 20, rue Laffitte, 75009 Paris, France. 2. Hôpital d'instruction des Armées-Begin, 69, avenue de Paris, 94160 Saint-Mandé, France. 3. Service d'orthopédie traumatologie, centre hospitalier universitaire de Grenoble, hôpital Sud, 38434 Échirolles cedex, France. 4. Cabinet Goethe, 23, avenue Niel, 75017 Paris, France. 5. Lyon-ortho-clinic, 29B, avenue des Sources-Bâtiment-Trait-d'Union, 69009 Lyon, France. 6. Médipole Garonne, 45, rue de Gironis, 31100 Toulouse, France. 7. Clinique du sport de merignac, 4, rue Negrevergne, 33700 Mérignac, France. 8. Service d'orthopédie traumatologie, centre hospitalo-universitaire de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France. 9. Cabinet médical ICOS, 118, rue Jean-Mermoz, 13008 Marseille, France. 10. Service d'orthopédie traumatologie, hôpitaux universitaire de Strasbourg, 67091 Strasbourg, France. 11. Centre Santy, 24, avenue Paul-Santy, 69008 Lyon, France. 12. Service d'orthopédie traumatologie, centre hospitalier de Versailles, 78150 le Chesnay, France. Electronic address: pboisrenoult@ch-versailles.fr.
Abstract
INTRODUCTION: Management of combined anterior or posterior cruciate ligament and posterolateral corner tears is still poorly codified. The aim of this study was to evaluate functional outcome after complete surgical treatment. MATERIALS AND METHODS: This retrospective multicenter study included 53 patients. Mean age was 29.8 yrs. (15-49). The anterior and posterior cruciate ligaments were involved in respectively 48 and 5 cases. Mean time to surgery was 25.6 months (0-184), and in 10 cases less than 21 days. Nine patients were sedentary workers and 29 non-sedentary (13 laborers). All ligament injuries were treated surgically. Mean follow-up was 49 months (12-146). Last follow-up assessment used IKDC, Lysholm and KOOS scores. RESULTS: At last follow-up, IKDC score graded 14 patients A, 25 B, 8 C and 6 D, versus 0 A, 4 B, 25 C, 22 D and 2 ungraded preoperatively. Mean subjective IKDC and Lysholm scores were respectively 72.8 (11.5-100) and 77.5 (37-100). Mean KOOS scores (pain, symptoms, daily life, sports, quality of life) were respectively 78 (3-100), 70 (25-100), 88 (47-100), 53 (0-100) and 50 (0-100). Posterolateral laxity was corrected in all but two cases. All sedentary workers and 86.7% of non-sedentary workers could return to work. The job had to be changed in 10% of cases overall, but in 25% of cases for laborers. DISCUSSION: The present results are comparable with those of the literature. The strategy of combined surgical treatment showed functional efficacy, usually associated with return to work except for some laborers. There was a non-significant trend in favor of acute-phase ligament reconstruction. LEVEL OF EVIDENCE: IV (retrospective series).
INTRODUCTION: Management of combined anterior or posterior cruciate ligament and posterolateral corner tears is still poorly codified. The aim of this study was to evaluate functional outcome after complete surgical treatment. MATERIALS AND METHODS: This retrospective multicenter study included 53 patients. Mean age was 29.8 yrs. (15-49). The anterior and posterior cruciate ligaments were involved in respectively 48 and 5 cases. Mean time to surgery was 25.6 months (0-184), and in 10 cases less than 21 days. Nine patients were sedentary workers and 29 non-sedentary (13 laborers). All ligament injuries were treated surgically. Mean follow-up was 49 months (12-146). Last follow-up assessment used IKDC, Lysholm and KOOS scores. RESULTS: At last follow-up, IKDC score graded 14 patients A, 25 B, 8 C and 6 D, versus 0 A, 4 B, 25 C, 22 D and 2 ungraded preoperatively. Mean subjective IKDC and Lysholm scores were respectively 72.8 (11.5-100) and 77.5 (37-100). Mean KOOS scores (pain, symptoms, daily life, sports, quality of life) were respectively 78 (3-100), 70 (25-100), 88 (47-100), 53 (0-100) and 50 (0-100). Posterolateral laxity was corrected in all but two cases. All sedentary workers and 86.7% of non-sedentary workers could return to work. The job had to be changed in 10% of cases overall, but in 25% of cases for laborers. DISCUSSION: The present results are comparable with those of the literature. The strategy of combined surgical treatment showed functional efficacy, usually associated with return to work except for some laborers. There was a non-significant trend in favor of acute-phase ligament reconstruction. LEVEL OF EVIDENCE: IV (retrospective series).
Authors: Patricia M Lutz; Michael Merkle; Philipp W Winkler; Stephanie Geyer; Elmar Herbst; Sepp Braun; Andreas B Imhoff; Matthias J Feucht Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-01-23 Impact factor: 4.342