Jae-Gwang Song1, Hyun-Jung Kim2, Jae Hwi Han1, Nikhl N Bhandare3, Gautam M Shetty4, Seung-Baik Kang5, Young Woong Song1, Kyung Wook Nha6. 1. Department of Orthopedic Surgery, Inje University, Ilsan Paik Hospital, Ilsan, Republic of Korea. 2. Department of Preventive Medicine, Korea University, Korea Anam Hospital, Seoul, Republic of Korea. 3. Department of Orthopedic Surgery, Bhandare Hospital, Panaji, India. 4. Asian Orthopedic Institute, Asian Heart Institute and Research Centre, Mumbai, India. 5. Department of Orthopedic Surgery, Seoul National University Boramae Hospital, Seoul, Republic of Korea. 6. Department of Orthopedic Surgery, Inje University, Ilsan Paik Hospital, Ilsan, Republic of Korea. Electronic address: kwnhamj@hotmail.com.
Abstract
PURPOSE: The purpose of this study was to analyze clinical outcomes in patients who underwent posterior cruciate ligament reconstruction (PCLR) with and without remnant preservation. METHODS: A search of the literature was performed with the established medical databases Medline, Embase, and the Cochrane Register. Two authors screened the selected articles for title, abstract, and full text in accordance with predefined inclusion and exclusion criteria. The inclusion criteria were as follows: English-language articles on isolated posterior cruciate ligament injury; clinical trials with a clear description of surgical technique; outcome evaluation using a well-defined knee score, arthrometry, and posterior stress radiography; follow-up longer than 2 years; and a Coleman Methodology Score (CMS) of 65 points or greater. The methodologic quality of all articles was assessed by 2 authors according to the CMS. RESULTS: Eleven studies were included, with a mean CMS of 78.9 points (SD, 5.37 points). There was no direct comparative study between remnant-preserving PCLR and standard PCLR. At final follow-up, the knees of 72% to 100% of patients who underwent remnant-preserving PCLR and 41% to 95% of patients who underwent standard PCLR were rated as normal or nearly normal on the International Knee Documentation Committee subjective knee assessment. Patients who underwent remnant-preserving PCLR showed an increase of 16.4 to 47 points in Lysholm scores, and patients who underwent standard PCLR showed an increase of 22 to 29 points. The ranges of mean postoperative side-to-side differences on KT-1000 (MEDmetric, San Diego, CA) testing were 0.7 to 2.8 mm in patients who underwent remnant-preserving PCLR and 1 to 3.5 mm in patients who underwent standard PCLR. The ranges of mean postoperative side-to-side differences on stress radiography were 2.2 to 5 mm in patients who underwent remnant-preserving PCLR and 4.7 to 6 mm in patients who underwent standard PCLR. CONCLUSIONS: All studies on PCLR with remnant preservation showed satisfactory outcomes despite using numerous surgical techniques, graft types, intervals from injury to surgery, and follow-up periods. LEVEL OF EVIDENCE: Level IV, systematic review of Level II through IV studies.
PURPOSE: The purpose of this study was to analyze clinical outcomes in patients who underwent posterior cruciate ligament reconstruction (PCLR) with and without remnant preservation. METHODS: A search of the literature was performed with the established medical databases Medline, Embase, and the Cochrane Register. Two authors screened the selected articles for title, abstract, and full text in accordance with predefined inclusion and exclusion criteria. The inclusion criteria were as follows: English-language articles on isolated posterior cruciate ligament injury; clinical trials with a clear description of surgical technique; outcome evaluation using a well-defined knee score, arthrometry, and posterior stress radiography; follow-up longer than 2 years; and a Coleman Methodology Score (CMS) of 65 points or greater. The methodologic quality of all articles was assessed by 2 authors according to the CMS. RESULTS: Eleven studies were included, with a mean CMS of 78.9 points (SD, 5.37 points). There was no direct comparative study between remnant-preserving PCLR and standard PCLR. At final follow-up, the knees of 72% to 100% of patients who underwent remnant-preserving PCLR and 41% to 95% of patients who underwent standard PCLR were rated as normal or nearly normal on the International Knee Documentation Committee subjective knee assessment. Patients who underwent remnant-preserving PCLR showed an increase of 16.4 to 47 points in Lysholm scores, and patients who underwent standard PCLR showed an increase of 22 to 29 points. The ranges of mean postoperative side-to-side differences on KT-1000 (MEDmetric, San Diego, CA) testing were 0.7 to 2.8 mm in patients who underwent remnant-preserving PCLR and 1 to 3.5 mm in patients who underwent standard PCLR. The ranges of mean postoperative side-to-side differences on stress radiography were 2.2 to 5 mm in patients who underwent remnant-preserving PCLR and 4.7 to 6 mm in patients who underwent standard PCLR. CONCLUSIONS: All studies on PCLR with remnant preservation showed satisfactory outcomes despite using numerous surgical techniques, graft types, intervals from injury to surgery, and follow-up periods. LEVEL OF EVIDENCE: Level IV, systematic review of Level II through IV studies.
Authors: Kyoung Ho Yoon; Jung-Suk Kim; Jae-Young Park; Soo Yeon Park; Raymond Yeak Dieu Kiat; Sang-Gyun Kim Journal: Orthop J Sports Med Date: 2021-02-23
Authors: Philipp W Winkler; Bálint Zsidai; Nyaluma N Wagala; Jonathan D Hughes; Alexandra Horvath; Eric Hamrin Senorski; Kristian Samuelsson; Volker Musahl Journal: Knee Surg Sports Traumatol Arthrosc Date: 2020-10-30 Impact factor: 4.342