No difference between single and staged posterolateral corner surgical procedures in the multiligament injured/dislocated knee

Benjamin Freychet, Nicholas I. Kennedy, Thomas L. Sanders, Nathan M. Levy, Devin P. Leland, Aaron J. Krych, Michael J. Stuart, Bruce A. Levy

Research output: Contribution to journalArticle

Abstract

Purpose: Posterolateral corner (PLC) injuries commonly occur in the setting of a dislocated knee and often require multiple procedures due to concomitant vascular, nerve, and soft tissue involvement. Debate persists regarding single vs staged surgery. The purpose of this study was to compare knee function after single and staged surgery for PLC injury. Methods: Patients who underwent surgery for a PLC injury (KD I, IIIL, IV) with minimum follow-up of 2 years were included. Patients treated with staged and single surgery were matched according to age, sex, and KD grade. Lysholm and International Knee Documentation Committee (IKDC) subjective scores were obtained. Risk factors for poor knee function were assessed, including age, nerve, vascular, meniscal and articular cartilage injuries. Results: Twenty single-surgery patients with a median age of 24 years (median follow-up 5.3 years, range 2–18.3) and 20 staged surgery patients with a median age of 26 years (median follow-up 4.3 years, range 2–19.8) were studied. The mean Lysholm score was 78.7 (± 20.3) in the single surgery and 84.2 (± 17.8) in the staged surgery cohort (n.s.). The mean IKDC score was 80.8 (± 21.1) in the single and 74.9 (± 18.9) in the staged surgery cohort (n.s.). Age at injury, peroneal, vascular, meniscal or cartilage injury were not associated with poor knee outcome. Conclusion: This study demonstrates similar knee function among patients with PLC injuries treated with single or staged surgical procedures. The need for staged surgery for the dislocated knee with PLC involvement should be individualized based on specific knee and patient-related factors. Level of evidence: III.

Original languageEnglish (US)
JournalKnee Surgery, Sports Traumatology, Arthroscopy
DOIs
StateAccepted/In press - Jan 1 2020

Fingerprint

Knee
Wounds and Injuries
Documentation
Blood Vessels
Nerve Tissue
Vascular System Injuries
Articular Cartilage
Cartilage

Keywords

  • IKDC
  • Knee dislocation
  • Lysholm
  • Posterolateral corner
  • Staged surgery

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

No difference between single and staged posterolateral corner surgical procedures in the multiligament injured/dislocated knee. / Freychet, Benjamin; Kennedy, Nicholas I.; Sanders, Thomas L.; Levy, Nathan M.; Leland, Devin P.; Krych, Aaron J.; Stuart, Michael J.; Levy, Bruce A.

In: Knee Surgery, Sports Traumatology, Arthroscopy, 01.01.2020.

Research output: Contribution to journalArticle

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abstract = "Purpose: Posterolateral corner (PLC) injuries commonly occur in the setting of a dislocated knee and often require multiple procedures due to concomitant vascular, nerve, and soft tissue involvement. Debate persists regarding single vs staged surgery. The purpose of this study was to compare knee function after single and staged surgery for PLC injury. Methods: Patients who underwent surgery for a PLC injury (KD I, IIIL, IV) with minimum follow-up of 2 years were included. Patients treated with staged and single surgery were matched according to age, sex, and KD grade. Lysholm and International Knee Documentation Committee (IKDC) subjective scores were obtained. Risk factors for poor knee function were assessed, including age, nerve, vascular, meniscal and articular cartilage injuries. Results: Twenty single-surgery patients with a median age of 24 years (median follow-up 5.3 years, range 2–18.3) and 20 staged surgery patients with a median age of 26 years (median follow-up 4.3 years, range 2–19.8) were studied. The mean Lysholm score was 78.7 (± 20.3) in the single surgery and 84.2 (± 17.8) in the staged surgery cohort (n.s.). The mean IKDC score was 80.8 (± 21.1) in the single and 74.9 (± 18.9) in the staged surgery cohort (n.s.). Age at injury, peroneal, vascular, meniscal or cartilage injury were not associated with poor knee outcome. Conclusion: This study demonstrates similar knee function among patients with PLC injuries treated with single or staged surgical procedures. The need for staged surgery for the dislocated knee with PLC involvement should be individualized based on specific knee and patient-related factors. Level of evidence: III.",
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AU - Freychet, Benjamin

AU - Kennedy, Nicholas I.

AU - Sanders, Thomas L.

AU - Levy, Nathan M.

AU - Leland, Devin P.

AU - Krych, Aaron J.

AU - Stuart, Michael J.

AU - Levy, Bruce A.

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N2 - Purpose: Posterolateral corner (PLC) injuries commonly occur in the setting of a dislocated knee and often require multiple procedures due to concomitant vascular, nerve, and soft tissue involvement. Debate persists regarding single vs staged surgery. The purpose of this study was to compare knee function after single and staged surgery for PLC injury. Methods: Patients who underwent surgery for a PLC injury (KD I, IIIL, IV) with minimum follow-up of 2 years were included. Patients treated with staged and single surgery were matched according to age, sex, and KD grade. Lysholm and International Knee Documentation Committee (IKDC) subjective scores were obtained. Risk factors for poor knee function were assessed, including age, nerve, vascular, meniscal and articular cartilage injuries. Results: Twenty single-surgery patients with a median age of 24 years (median follow-up 5.3 years, range 2–18.3) and 20 staged surgery patients with a median age of 26 years (median follow-up 4.3 years, range 2–19.8) were studied. The mean Lysholm score was 78.7 (± 20.3) in the single surgery and 84.2 (± 17.8) in the staged surgery cohort (n.s.). The mean IKDC score was 80.8 (± 21.1) in the single and 74.9 (± 18.9) in the staged surgery cohort (n.s.). Age at injury, peroneal, vascular, meniscal or cartilage injury were not associated with poor knee outcome. Conclusion: This study demonstrates similar knee function among patients with PLC injuries treated with single or staged surgical procedures. The need for staged surgery for the dislocated knee with PLC involvement should be individualized based on specific knee and patient-related factors. Level of evidence: III.

AB - Purpose: Posterolateral corner (PLC) injuries commonly occur in the setting of a dislocated knee and often require multiple procedures due to concomitant vascular, nerve, and soft tissue involvement. Debate persists regarding single vs staged surgery. The purpose of this study was to compare knee function after single and staged surgery for PLC injury. Methods: Patients who underwent surgery for a PLC injury (KD I, IIIL, IV) with minimum follow-up of 2 years were included. Patients treated with staged and single surgery were matched according to age, sex, and KD grade. Lysholm and International Knee Documentation Committee (IKDC) subjective scores were obtained. Risk factors for poor knee function were assessed, including age, nerve, vascular, meniscal and articular cartilage injuries. Results: Twenty single-surgery patients with a median age of 24 years (median follow-up 5.3 years, range 2–18.3) and 20 staged surgery patients with a median age of 26 years (median follow-up 4.3 years, range 2–19.8) were studied. The mean Lysholm score was 78.7 (± 20.3) in the single surgery and 84.2 (± 17.8) in the staged surgery cohort (n.s.). The mean IKDC score was 80.8 (± 21.1) in the single and 74.9 (± 18.9) in the staged surgery cohort (n.s.). Age at injury, peroneal, vascular, meniscal or cartilage injury were not associated with poor knee outcome. Conclusion: This study demonstrates similar knee function among patients with PLC injuries treated with single or staged surgical procedures. The need for staged surgery for the dislocated knee with PLC involvement should be individualized based on specific knee and patient-related factors. Level of evidence: III.

KW - IKDC

KW - Knee dislocation

KW - Lysholm

KW - Posterolateral corner

KW - Staged surgery

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