Evaluation of knee stability after simulated reconstruction of the core ligament of the posterolateral complex / 中国组织工程研究

ABSTRACT

BACKGROUND: Injury of the posterolateral complex of the knee joint is a common type of multiple ligament injuries of the knee joint. The reconstruction of the posterolateral complex can restore the posterior and lateral stability of the knee joint and rebuild the stability of the knee joint. OBJECTIVE: To discuss the feasibility and clinical effect of modified LaPrade method for functional reconstruction of posterolateral complex of knee with autograft peroneus longus tendon. METHODS: Fourteen patients with posterolateral complex and posterior cruciate ligament injuries who were treated in the Department of Orthopedics, Affiliated Hospital of Zunyi Medical University from October 2014 to March 2017 were enrolled in this study. Posterior cruciate ligament and posterolateral complex were simultaneously constructed in stage one. The injury of the posterolateral complex of the knee joint was Fanelli type C. Modified LaPrade method was used to functional reconstruction of posterolateral complex of knee with peroneus longus tendon. The anatomy and function of the core ligament of the posterolateral complex was simulated. Follow-up time was beyond 1 year. The tibia posterior displacement on stress radiographs, lateral compartment gapping on varus stress radiographs at 0° knee extension, and external rotation angle of tibia at 30° knee flexion were compared before and after surgery. The joint function was evaluated according to the score of International Knee Documentation Committee and Lysholm Knee score. RESULTS AND CONCLUSION: (1) All patients were followed up for 12-18 months. All patients had no knee-length restriction, with flexion limitation in some patients. (2) At the last follow-up, the tibia posterior displacement on stress radiographs, lateral compartment gapping on varus stress radiographs and external rotation angle of tibia at 30° knee flexion were reduced from preoperation, with statistically significant differences (P=0.000). (3) The International Knee Documentation Committee function was corrected from D preoperatively to A in 8 cases and B in 6 cases postoperatively. The average Lysholm score was increased from (32.4±5.6) preoperatively to (82.7±6.4) postoperatively, and the differences were statistically significant (P=0.000). (4) It is indicated that with peroneus longus tendon, the anatomy and function of the core ligament of the posterolateral complex were simulated by modified LaPrade method to functional reconstruction of posterolateral complex of knee, and the postoperative knee function recovered well.