Open AccessCombined posterolateral knee reconstruction: ACL‐based injuries perform better compared to PCL‐based injuries
Author(s) -
Lutz Patricia M.,
Merkle Michael,
Winkler Philipp W.,
Geyer Stephanie,
Herbst Elmar,
Braun Sepp,
Imhoff Andreas B.,
Feucht Matthias J.
Publication year - 2021
Publication title -
knee surgery, sports traumatology, arthroscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.806
H-Index - 125
eISSN - 1433-7347
pISSN - 0942-2056
DOI - 10.1007/s00167-020-06409-3
Subject(s) - medicine , anterior cruciate ligament , posterior cruciate ligament , return to sport , acl injury , physical therapy , surgery , osteoarthritis , rehabilitation , alternative medicine , pathology
Purpose To compare post‐operative physical activity and return to work after combined posterolateral corner (PLC) reconstruction (PLC‐R) in anterior cruciate ligament (ACL)‐ or posterior cruciate ligament (PCL)‐based injuries. Methods Patients aged > 18 years undergoing PLC‐R using the Larson technique combined with either ACL or PCL reconstruction were included. Outcome was evaluated retrospectively after a minimum follow‐up of 24 months using Tegner Activity Scale, Activity Rating Scale (ARS), Knee Injury and Osteoarthritis Outcome Score (KOOS), work intensity according to REFA classification, and a questionnaire about type of occupation and time to return to work. Results A total of 32 patients (11 ACL‐based injuries and 21 PCL‐based injuries) were included. Mean follow‐up was 56 ± 26 months in the ACL‐based injury group and 59 ± 24 months in the PCL‐based injury group. All patients in the ACL‐based injury group and 91% of patients in the PCL‐based injury group returned to sports activities. Comparing pre‐ and post‐operative values, a significant deterioration of the Tegner Activity Scale and ARS was observed in the PCL‐based injury group, whereas no significant change was observed in the ACL‐based injury group. KOOS subscales were generally higher in the ACL‐based injury with significant differences in the subscale sports and recreational activities. Patients with ACL‐based injuries returned to work significantly earlier compared to patients with PCL‐based injuries (11 ± 4 weeks vs. 21 ± 10 weeks, p < 0.05). Conclusion High rates of return to sports and work can be expected after combined PLC‐R in both ACL‐ and PCL‐based injuries. However, deterioration of sports ability must be expected in PCL‐based injuries. ACL‐based injuries led to superior patient‐reported outcomes and an earlier return to work, as compared to PCL‐based injuries. Level of evidence Level IV.