Combined anterior cruciate ligament and posterolateral corner reconstruction in chronic instabilities

Abstract

Background Combined anterior cruciate ligament (ACL) and posterolateral corner (PLC) injury is not an uncommon knee injury. Missed PLC injuries are the main cause of ACL reconstruction failure. Combined reconstruction of ACL and PLC is recommended for these injuries. However, the main disadvantages of the combined reconstruction are the possibility of tunnel convergence. Aim The aim of this study was to evaluate functional results of simultaneous reconstruction of ACL and PLC over a 2-year follow-up. Setting and design A case series study was held at Alexandria University. Patients and methods From 2012 to 2014, 23 patients had concomitant ACL with posterolateral instability. All cases underwent a simultaneous PLC reconstruction with the ACL reconstruction. The median age of the participants was 32 years (range: 23–39 years). The median follow-up was 32 months (range: 24–38 months). There were 22 males and one female. The median duration from the time of injury to the operation was 5 months. International Knee Documentation Committee and Lysholm score were used for the evaluation of the results. Statistical analysis MedCalc was used for statistical analysis. Results Based on the International Knee Documentation Committee evaluation form the last evaluation, 15 of the 23 patients (65%) were rated as A (normal), whereas five (21%) were rated as B (nearly normal), two (8%) as C (nearly abnormal), and one (4%) as D (abnormal). According to Lysholm score, the overall results were excellent in 22 patients (95% of the patients). The median Lysholm score improved from 56 points preoperatively to 94 points postoperatively. Only one patient had poor score owing to residual rotational instability. Conclusion Combined reconstruction of ACL and PLC had very good results over a 2-year follow-up, with no residual laxity in most of the patients.