Delayed multiligament PCL reconstruction is associated with a higher prevalence of intraarticular injury and may influence treatment

BMC Musculoskeletal Disorders

Research

Ryan T. Lin¹  Ehab M. Nazzal¹  Ian D. Engler²  Volker Musahl³  Bálint Zsidai⁴  Philipp W. Winkler⁵  James J. Irrgang⁶  Eric Narup⁷  Kristian Samuelsson⁸ 

[1] Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh, Pittsburgh, USA;Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh, Pittsburgh, USA;Central Maine Healthcare Orthopedics, Central Maine Medical Center, Auburn, USA;Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh, Pittsburgh, USA;Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh, Pittsburgh, USA;Sahlgrenska Sports Medicine Center, Gothenburg, Sweden;Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Department of Orthopaedics and Traumatology, Kepler University Hospital Linz, Linz, Austria;Department of Sports Orthopaedics, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany;Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, USA;Sahlgrenska Sports Medicine Center, Gothenburg, Sweden;Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Sahlgrenska Sports Medicine Center, Gothenburg, Sweden;Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden;

关键词: Posterior cruciate ligament;    PCL;    Surgical timing;    Multiligament;    Knee injury;    Meniscus tear;    Cartilage injury;    Knee ligament;   

DOI  :  10.1186/s12891-023-06638-w

 received in 2023-04-12, accepted in 2023-06-15,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe aim of this study was to investigate differences in concomitant injury patterns and their treatment in patients undergoing early (≤ 12 weeks) and delayed (> 12 weeks) primary multiligament posterior cruciate ligament (PCL) reconstruction (PCL-R).MethodsThis study was a retrospective chart review of patients undergoing primary multiligament PCL-R at a single institution between 2008 and 2020. Multiligament PCL-R was defined as PCL-R and concurrent surgical treatment of one or more additional knee ligament(s). Exclusion criteria included isolated PCL-R, PCL repair, and missing data for any variable. Patients were dichotomized into early (≤ 12 weeks) and delayed (> 12 weeks) PCL-R groups based on the time elapsed between injury and surgery. Between-group comparison of variables were conducted with the Chi-square, Fisher’s exact, and independent samples t-tests.ResultsA total of 148 patients were eligible for analysis, with 57 (38.5%) patients in the early and 91 (61.1%) patients in the delayed multiligament PCL-R groups. Concomitant LCL/PLC reconstruction (LCL-R/PLC-R) was performed in 55 (60%) of delayed multiligament PCL-Rs and 23 (40%) of early PCL-Rs (p = 0.02). Despite similar rates of meniscus injury, concomitant meniscus surgery was significantly more prevalent in the early (n = 25, 44%) versus delayed (n = 19, 21%) multiligament PCL-R group (p = 0.003), with a significantly greater proportion of medial meniscus surgeries performed in the early (n = 16, 28%) compared to delayed (n = 13, 14%) PCL-R group (p = 0.04). The prevalence of knee cartilage injury was significantly different between the early (n = 12, 24%) and delayed (n = 41, 46%) multiligament PCL-R groups (p = 0.01), with more frequent involvement of the lateral (n = 17, 19% vs. n = 3, 5%, respectively; p = 0.04) and medial (n = 31, 34% vs. n = 6, 11%, respectively; p = 0.005) femoral condyles in the delayed compared to the early PCL-R group.ConclusionsGiven higher rates of chondral pathology and medial meniscus surgery seen in delayed multiligament PCL-R, early management of PCL-based multiligament knee injury is recommended to restore knee stability and potentially prevent the development of further intraarticular injury.Level of evidenceLevel III.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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