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Association of Posterior Tibial Slope With Outcomes After Multiligamentous Knee Reconstruction for Knee Dislocation Grades 2 to 4.
Conyer, Ryan T; Wang, Allen S; Langhans, Mark T; Krych, Aaron J; Hevesi, Mario; Okoroha, Kelechi R; Stuart, Michael J; Levy, Bruce A.
Afiliación
  • Conyer RT; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Wang AS; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Langhans MT; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Krych AJ; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Hevesi M; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Okoroha KR; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Stuart MJ; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Levy BA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Orthop J Sports Med ; 12(5): 23259671241249473, 2024 May.
Article en En | MEDLINE | ID: mdl-38757069
ABSTRACT

Background:

Patients with isolated anterior cruciate ligament (ACL) reconstruction have demonstrated an increased risk of ACL graft failure and lower patient-reported outcome (PRO) scores when increased posterior tibial slope (PTS) is present. However, there is a paucity of literature evaluating the effect of PTS on outcomes after combined bicruciate multiligamentous knee reconstruction.

Purpose:

To determine whether differences exist for graft failure rates or PRO scores based on PTS after combined bicruciate multiligamentous knee reconstruction. Study

Design:

Cohort study; Level of evidence, 3.

Methods:

All patients who underwent combined ACL and posterior cruciate ligament (PCL) reconstruction between 2000 and 2020 at our institution were identified. Exclusion criteria were age <18 years, knee dislocation grade 5 injuries, concomitant osteotomy procedures, and <2 years of clinical follow-up. Demographic and outcomes data were collected from our prospectively gathered multiligamentous knee injury database. Lysholm and International Knee Documentation Committee (IKDC) scores were analyzed in relation to PTS. Outcomes were compared for patients with a PTS above and below the mean for the total cohort, PTS >12° versus <12°, positive versus negative Lachman test at follow-up, and positive versus negative posterior drawer test at follow-up.

Results:

A total of 98 knees in 98 patients were included in the study, with a mean clinical follow-up of 5.1 years (median, 4.6 years; range, 2-16 years). The mean PTS was 8.7° (range, 0.4°-16.9°). Linear regression analysis showed no significant correlation between PTS and IKDC or Lysholm scores. Patients with a PTS above the mean of 8.7° trended toward lower IKDC (P = .08) and Lysholm (P = .06) scores. Four patients experienced ACL graft failure and 5 patients experienced PCL graft failure. There were no differences in graft failure rates or PRO scores for patients with a PTS >12°. Patients with a positive Lachman test trended toward higher PTS (9.6° vs 8.5°, P = .15).

Conclusion:

In this series of bicruciate multiligamentous knee reconstructions at midterm follow-up, no differences in graft failures, complications, reoperations, revisions, or PRO scores based on PTS were identified. Patients with a positive Lachman test were found to have a slightly higher PTS, although this did not reach statistical significance.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Orthop J Sports Med Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Orthop J Sports Med Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos