SYSTEMATIC REVIEW FOR MANAGEMENT OF POSTEROLATERAL CORNER INJURIES OF THE KNEE

Abstract

Background: There is a paucity of outcome data to guide the surgical
treatment of posterolateral corner knee injuries.
Purpose: To systematically review the literature to compare clinical
outcomes of the treatment PLC injuries.
Study Design: Systematic review; Level of evidence, 4.
Methods: A systematic review of the literature including PubMed
was performed. The following search terms were used: “posterolateral
corner”, “chronic PLC injuries” “acute PLC injuries” and “repair of
PLC injuries”, “reconstruction of PLC”. Inclusion criteria were:
Human examinations and treatment, measures of functional and
clinical outcome included, exclusion criteria were: Non English
papers, Non-human trials, Articles with no clinical data.
Results: Eighteen studies with a total of 559 patients were included.
When time to surgery was performed within 6 weeks it is considered
acute injury while on the other hand more than that was considered
chronic injury. Surgical treatment varied between repair and
reconstruction there was an overall success rate of repair 75% and
failure rate of 25% and overall success rate of reconstruction was 91%
and 9% failure rate.
Surgical techniques: 83 patients underwent repair for the PLC while
476 patients underwent reconstruction for the PLC, surgical
techniques varied among studies, between repair and reconstruction
techniques which was different between studies, including fibular
sling using one femoral tunnel or two femoral tunnels, posterolateral
capsular shift trying to increase rotational stability, anatomic PLC
reconstruction, biceps tenodesis and isometric reconstruction of the
FCL and the popliteus with a single graft.
Conclusion: The repair of acute PLC injuries and staged treatment of
combined cruciate injuries were associated with a substantially higher
postoperative PLC failure rate than reconstruction. Further research is
required to identify the reconstruction technique that provides optimal
subjective and objective outcomes.
Key words: posterolateral corner, chronic PLC injuries, acute PLC
injuries and repair of PLC injuries, reconstruction of PLC.