Abstract
Objective To assess the clinical outcomes of posterolateral comer(PLC)reconstruction protocols in the treatment of traumatic multi-ligament injury or dislocation of the knee.Methods PLC reconstruction was performed consecutively for 85 patients with chronic posterolateral instability of the knee from July 2003 to November 2008.The inclusion criteria for surgery were multi-ligament injury and PLC injury with/without varus laxity and with tibial extorsion 10° greater than the normal.According to Fanelli classification,the popliteofibular ligament(PFL)or popliteal tendon was reconstructed for the type A PLC injury(48cases),while the split Achilles tendon reconstruction or lateral collateral ligament(LCL)and popliteal tendon reconstruction or Ⅹ shape reconstruction were chosen for the type C injury(37 cases).Results The average follow-up was 38.5 months.The average posterior tibial translation was reduced from preoperative16.7 ± 5.3 mm to post-operative 5.1 ± 3.8 mm in type A group and reduced from 14.9 ± 4.4 mm to 5.4 ±4.2 mm in type C group.The tibial extorsion was decreased from an average of 16.7°±4.7° preoperatively to-1.8°± 6.6° postoperatively in type A group and from 16.2°± 9.9° to-3.0°± 8.6° in type C group,as compared with the normal knee.The lateral compartment opening measured from stress view was decreased from 13.8 ±2.6 mm to 8.6 ±2.7 mm.These differences were statistically significant(P < 0.05).By International Knee Documentation Committee(IKDC)grades,preoperatively 2 patients were of grade C and 56 of grade D,but postoperatively31 were of grade A,15 of grade B and 12 of grade C.Conclusion In the treatment of traumatic multi-ligament injury or dislocation of the knee,PLC reconstruction protocols based on the Fanelli' s classification can effectively correct the posterior and posterolateral instability. Key words: Collateral ligament; Posterior crueiate ligament; Anterior cruciate ligament; Arthroplasty; Posterolateral corner
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