als PDF - AGA

Knie
AGA2012-184
Langfristige Ergebnisse der kombinierten vorderen Kreuzbandes und posterolaterale Ecke
Behandlung
Long-term results of combined anterior cruciate ligament and posterolateral corner treatment
Authors
* Konstantinos Makridis Cabinet Goethe-Clinique Nollet, Paris, France
Anthony Wajsfisz Cabinet Goethe-Clinique Nollet, Paris, France
Miltiadis Georgoussis Cabinet Goethe-Clinique Nollet, Paris, France
Patrick Djian Cabinet Goethe-Clinique Nollet, Paris, France
Abstract
Fragstellung: This retrospective study presents the treatment outcome of the combined anterior cruciate
ligament and posterolateral corner injuries. The long-term results as well as a detailed description of the specific
surgical techniques and their efficacy in the management of sports injuries are reported.
Methodik: Twenty six men and four women were operated for combined antero-posterolateral instability. Nine
patients had combined ACL, lateral collateral ligament (LCL), posterolateral corner (PLC) and popliteus tendon
(PT) ruptures. Sixteen patients had combined ACL, LCL and PC lesions. Three patients had a combined ACL, PT
and PC injuries. Two patients had combined ACL and LCL ruptures. The IKDC forms, KT-1000, Telos stress
radiographs and MRI used to assess the results of this retrospective study. Quantitative data recorded and
statistically analyzed with the use of Student t-test for unpaired and paired samples. Qualitative data were
analyzed with the use of Pearson chi-square test. Data with no normal distribution were analyzed using the nonparametric
Mann-Whitney test and Fisher exact test. Significance levels were set at P < 0.05 with confidence
intervals at 95%.
Ergebnis: There were 17 right and 13 left knees. The median age of patients was 31.6 years (range 15-57). The
median operative time was 90.4 minutes (range 60-120). Anterior cruciate ligament (ACL) reconstruction was
made in all cases. Lateral collateral ligament reconstruction (LCL) was made in 89% of the patients. Popliteus
tendon reconstruction was made in 60% of the patients. The posterolateral capsule has been repaired by simple
sutures in 100% of the patients. A high tibial osteotomy (medial, open wedge) was made in three patients who
presented with varus-knee deformity. The median follow-up was 30.3 months (12-90). The clinical examination
showed a normal range of motion in the majority of the patients. The median IKDC score was 81(range 51-100).
The IKDC values for the patients operated in less than three weeks after injury were superior to those of patients
operated more than three weeks. KT-1000 and Telos stress device examination revealed no cases with knee
instability.
Schlussfolgerung: The combined antero-posterolateral knee instabilities can be successfully treated by
simultaneous ACL and posterolateral corner reconstruction. An accurate diagnosis and the use of specific
treatment modalities can result in satisfactory treatment outcome.
Keywords
anteroposterolateral instability, knee, reconstruction
16.03.2012 149
Vortrag
(c) by CVS://Abstractmanagement