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Jackson GR, Mameri ES, Condon J, DeWald D, Batra A, Salazar LM, Familiari F, Matava M, Knapik DM, Verma NN, LaPrade RF, Chahla J. Non-anatomical reconstruction of chronic posterolateral corner knee injuries show failure rates from 0% to 36% versus 4.3% to 24.2% for anatomic reconstruction techniques: An updated systematic review reflecting the 2019 expert consensus statement. J ISAKOS 2024; 9:362-370. [PMID: 38042407 DOI: 10.1016/j.jisako.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 11/22/2023] [Accepted: 11/27/2023] [Indexed: 12/04/2023]
Abstract
OBJECTIVE To review and update the literature regarding outcomes following surgical management of chronic, grade III posterolateral corner (PLC) injuries, with an emphasis on estimating failure rates based upon objective parameters in light of the 2019 expert consensus, while secondarily comparing the failure rates of anatomic versus non-anatomic reconstruction techniques. METHODS A literature search was performed using the PubMed, Embase, MEDLINE, and Cochrane Library databases. Inclusion criteria consisted of level I-IV human clinical studies reporting subjective and objective outcomes in patients following surgical management for chronic (>6 weeks from injury) grade III PLC injuries, with a minimum two-year follow-up. The criterion for objective surgical failure was based on post-operative varus stress radiographs and defined as a side-to-side difference of 3 mm or more of lateral gapping. RESULTS A total of six studies, consisting of 10 separate cohorts encompassing a total of 230 patients, were identified. PLC reconstruction was performed in all cohorts, with 80 % (n = 8/10) of these cohorts utilising an anatomic reconstruction technique. A failure rate ranging from 4.3 % to 36 % was found. Subgroup analysis revealed a failure rate of 4.3 %-24.2 % for anatomic reconstruction techniques, whereas a 0 %-36 % failure rate was found for non-anatomic reconstruction. Arthrofibrosis was the most common complication (range, 0 %-12.1 %) following surgery. 0 %-8 % of patients required revision PLC surgery. CONCLUSION PLC reconstruction yields a wide variability in failure rates according to the side-to-side difference of 3 mm or more of lateral gapping on post-operative varus stress radiographs, with low revision rates following anatomic and non-anatomic reconstruction techniques. LEVEL OF EVIDENCE IV; Systematic Review of Level III and IV studies.
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Affiliation(s)
- Garrett R Jackson
- Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W Harrison St, Chicago, IL 60612, USA
| | - Enzo S Mameri
- Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W Harrison St, Chicago, IL 60612, USA; Instituto Brasil de Tecnologia da Saúde, 407 Visconde de Piraja St, Rio de Janeiro, RJ 22410, Brazil; Department of Orthopedics and Traumatology, Federal University of São Paulo (EPM-UNIFESP), 740 Botucatu St, São Paulo, SP 04023, Brazil
| | - Joshua Condon
- Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W Harrison St, Chicago, IL 60612, USA
| | - Daniel DeWald
- Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W Harrison St, Chicago, IL 60612, USA
| | - Anjay Batra
- Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W Harrison St, Chicago, IL 60612, USA
| | - Luis M Salazar
- Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W Harrison St, Chicago, IL 60612, USA
| | - Filippo Familiari
- Department of Orthopaedic and Trauma Surgery, Magna Graecia University of Catanzaro, Viale Europa, 88100 Catanzaro CZ, Italy
| | - Matthew Matava
- Department of Orthopaedic Surgery, Washington University and Barnes-Jewish Orthopedic Center, 14532 South Outer Forty Drive, Chesterfield, MO 63017, USA
| | - Derrick M Knapik
- Department of Orthopaedic Surgery, Washington University and Barnes-Jewish Orthopedic Center, 14532 South Outer Forty Drive, Chesterfield, MO 63017, USA
| | - Nikhil N Verma
- Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W Harrison St, Chicago, IL 60612, USA
| | - Robert F LaPrade
- Twin Cities Orthopedics, 4010 West 65th Street, Edina, MN 55435, USA
| | - Jorge Chahla
- Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W Harrison St, Chicago, IL 60612, USA.
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Kaneguchi A, Hayakawa M, Shimoe A, Takahashi A, Yamaoka K, Ozawa J. The effects of weight bearing after ACL reconstruction on joint contracture in rats. Connect Tissue Res 2023; 64:543-554. [PMID: 37403736 DOI: 10.1080/03008207.2023.2232881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/29/2023] [Accepted: 06/26/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE Joint contractures after anterior cruciate ligament (ACL) reconstruction are a serious problem. Given the uncertain effects of weight bearing after ACL reconstruction on contractures, this study was conducted to examine such effects. MATERIALS AND METHODS To control the amount of weight bearing, ACL-reconstructed rats were reared with either untreated (small weight bearing; weight bearing during locomotion was 54% of pre-surgery at minimum), hindlimb unloading (non-weight bearing), or sustained morphine administration (large weight bearing; weight bearing during locomotion was maintained at 80% or more of pre-surgery) conditions. Untreated rats were used as controls. Knee extension range of motions (ROMs) before (includes myogenic and arthrogenic factors) and after myotomy (includes arthrogenic factor only) and fibrotic reactions in the joint capsule were assessed 7 and 14 days post-surgery. RESULTS ACL reconstruction significantly reduced ROMs both before and after myotomy and induced fibrosis in the joint capsule accompanying upregulation of fibrosis-related genes (i.e., type I and III collagens and transforming growth factor-β1) at both time points. Morphine administration increased the ROM before myotomy, but not after myotomy 7 days post-surgery. Unloading after ACL reconstruction improved ROMs both before and after myotomy at both time points. In addition, unloading after ACL reconstruction attenuated fibrotic reactions in the joint capsule. CONCLUSIONS Our results suggest that morphine administration improves myogenic contractures in parallel with an increase in the amount of weight bearing. Unloading after ACL reconstruction is effective in reducing both myogenic and arthrogenic contractures.
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Affiliation(s)
- Akinori Kaneguchi
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Higashi-Hiroshima, Japan
| | - Momoka Hayakawa
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Higashi-Hiroshima, Japan
| | - Atsuhiro Shimoe
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Higashi-Hiroshima, Japan
| | - Akira Takahashi
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Higashi-Hiroshima, Japan
| | - Kaoru Yamaoka
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Higashi-Hiroshima, Japan
| | - Junya Ozawa
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Higashi-Hiroshima, Japan
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Monson JK, Schoenecker J, Matheson JW, O'Keefe J, Schwery N, Hickmann A. Modern Principles for Rehabilitation for Medial and Lateral Knee Ligament Surgery: How to Optimize Outcomes. OPER TECHN SPORT MED 2022. [DOI: 10.1016/j.otsm.2022.150915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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